Little P, Francis NA, Stuart B, et al. - In children presenting with uncomplicated chest infections, treatment with amoxicillin is unlikely to show clinical effectiveness either overall or for key subgroups in whom antibiotics are usually prescribed. Unless there is suspicion for pneumonia, clinicians are advised to offer safety-netting advice but not prescribe antibiotics for most children presenting with chest infections.

• In a double-blind, randomized, placebo-controlled trial (ARTIC PC), children presenting with uncomplicated (non-pneumonic) lower respiratory tract infection in primary care were included.

• They were randomized to receive amoxicillin 50 mg/kg per day or placebo oral suspension, in three divided doses orally for 7 days.

• Duration of symptoms rated moderately bad or worse for up to 28 days or until symptoms resolved, was the primary outcome.

• Similar mean durations of moderately bad or worse symptoms was evident between the groups (5 days [IQR 4–11] in the antibiotics group vs 6 days [4–15] in the placebo group; hazard ratio 1·13).

• In the five prespecified clinical subgroups (cases with chest signs, fever, physician rating of unwell, sputum or chest rattle, and short of breath), the primary outcome did not differ between the treatment groups.