For children with acute respiratory infections in hospital, it is desirable to transfer from parenteral to oral therapy at the earliest opportunity. The introduction of a pediatric suspension of cefuroxime axetil provides a continuous course of one antibiotic with transition from injectable to oral therapy. This open study was designed to investigate the efficacy of cefuroxime in pediatric patients aged 3 months to 5 years with community-acquired pneumonia. Children had evidence of lobar pneumonia on chest X-ray, a white blood cell count of > 15,000/mm3 and a rectal temperature of > or = 38.5 degrees C on enrollment. Cefuroxime was given by i.v. injection at 75 mg/kg per day in three divided doses for 48-72 h followed by oral cefuroxime suspension at 30 mg/kg per day in two divided doses. Of 84 evaluable patients 82 (97.6%) were cured or improved post-treatment, and of 74 evaluable children who returned for follow-up assessment 73 (98.6%) remained well. Oral therapy with twice daily cefuroxime axetil suspension following 2-3 days of i.v. cefuroxime administration was confirmed as effective and safe treatment for lobar pneumonia in children under 5 years of age.