By Laura MacInnis

GENEVA, Jan 4 (Reuters) - Treating children stricken with severe pneumonia at home, instead of sending them to hospital, could save scores of lives in poor nations, the World Health Organisation (WHO) said on Friday.

Citing a Boston University School of Public Health study it helped support, the WHO said that antibiotic pills given at home were as effective as injectible antibiotics against pneumonia, the largest killer of children under five years old.

Every minute, four children die from the lung inflammation, which can range in seriousness from mild to life-threatening. Pneumonia acquired in hospital can be particularly virulent.

Most developed-world cases of pneumonia develop from a viral infection, but in developing nations, where children are most affected, about 60 percent of cases are caused by bacteria that can be treated with antibiotics.

Under current WHO guidelines, children with mild pneumonia are given oral antibiotics and more severe cases are referred to hospitals for treatment with antibiotics by injection.

But in poor countries, families often cannot easily access hospitals, and many children die before they reach hospital or are too sick to be treated once they arrive.

"In addition, children with severe pneumonia are vulnerable to infections as a result of weak immunity and could be at increased risk in crowded hospital wards," according to the United Nations health agency.

It said it would revise its guidance this year in light of the research involving 2,037 children in Pakistan, which showed a treatment failure rate of 7.5 percent among children given drugs at home, compared to 8.6 percent among those in hospital.

Some children with very severe pneumonia will still require injectible antibiotics in hospital, the study found.

"The potential impact of these results is enormous," said Shamim Qazi, a medical officer with the WHO's department of child and adolescent health and development, who co-authored the study appearing in the Lancet medical journal.

"Being able to treat children with severe pneumonia safely and effectively in their own homes would be of huge benefit to both families and health systems, by reducing the need for admission to hospital," Qazi said.

A WHO spokeswoman said the oral antibiotic typically used to fight pneumonia is amoxicillin, a penicillin-based formulation also used for ear, bladder and other infections. Amoxicillin is produced by pharmaceutical companies including GlaxoSmithKline <GSK.L> and is also available as a generic medicine.

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