This is a pragmatic randomised controlled trial that seeks to compare injectable antibiotic treatments and tube feeding versus fluid treatment for children with severe pneumonia. specifically, the study aims to address two questions: (1) whether either intravenous amoxicillin-clavulanic acid or ceftriaxone is superior to benzylpenicillin plus gentamicin (standard care) for the treatment of children hospitalized with severe pneumonia and (2) therefore whether nasogastric feeding is superior to intravenous fluid therapy for supportive management of children with severe pneumonia. The study will enrol 4392 children at up to ten hospitals in Kenya, one in Tanzania, and one in Uganda.