A total of 110 consecutive hospitalized children with severe lower res
piratory tract infection were studied with the aim of determining the
main bacterial pathogens responsible. Of these, 57 were classified as
severe pneumonia and 53 as very severe pneumonia. Streptococcus pneumo
niae was the most common organism identified in 24.6% and 32.1% of cas
es of severe and very severe pneumonia, respectively, followed by Haem
ophilus influenzae type b, which was seen in 17.5% and 20.8%, respecti
vely. The highest diagnostic yield was with the latex particle aggluti
nation test on serum and urine. Blood culture was positive in only ten
of the 110 children. No difference was found between the aetiological
agents identified in severe and very severe cases of pneumonia. There
fore, the use of different parenteral antibiotics for two clinically d
efined groups of pneumonia, as recommended by WHO in their standard ca
se management guidelines for the ARI control programme, does not seem
necessary.