Efficacy and safety of short- versus standard-course ceftriaxone therapy in children with pneumonia: A randomized trial

Background: Pediatric bacterial pneumonia (30-40% of cases) is commonly treated with ceftriaxone sodium, but optimal duration (traditional 7-14 days vs. short 5-7 days) remains controversial. Objectives: To compare therapeutic efficacy, inflammatory marker dynamics and safety of short- vs. standard-course ceftriaxone sodium in pediatric pneumonia. Methods: This prospective, single-center, single-blind, phase randomized controlled trial randomized 200 children (1-14 years) 1:1 to short-course (5-7 days) or standard-course (7-14 days) ceftriaxone sodium. The primary outcome was overall response rate; secondary outcomes included symptom relief time, hospital stay, recurrence, adverse events, and changes in lung function and inflammatory markers. Results: Symptom relief time and overall efficacy were comparable between groups (P>0.05). Short-course ceftriaxone sodium reduced hospital stay and adverse events (P<0.05), while standard-course lowered recurrence rate and achieved superior inflammatory marker normalization by day 5 (P<0.05). Conclusion: Short- and standard-course ceftriaxone sodium have similar overall efficacy. A short-course is suitable for mild cases with a prompt inflammatory response, while a standard-course is preferred for severe cases or delayed inflammation to prevent relapse.