Table 1. WHO standard case management of pneumonia defined by age groups and severity of disease.

Standard Case Management
Diagnosis	Presenting signs and symptoms	Recommended treatment regimens
Child 2–59 months
Severe pneumonia	Respiratory rate (bpm):	Penicillin 50 000 units/kg 6 hourly for 3
	≥ 50 aged 2–11 months	days if improved then oral amoxicillin 25
	≥ 40 aged 12–59 months	mg/kg three times daily for total of 5 to 8
	Lower chest wall indrawing	days
Very severe	Respiratory rate (bpm):
pneumonia	≥ 50 aged 2–11 months	Chloramphenicol 25 mg/kg 8 hourly for 5
	≥ 40 aged 12–59 months	days if improved then three times daily for
	Lower chest wall indrawing	total of 10 days antibiotic treatment
	Cyanosis
	Unable to drink
	Reduced level of consciousness
	Grunting (infants)
Infant <2 months
Severe/Very severe	Respiratory rate (bpm):	Gentamicin 7.5 mg/kg once daily for 8 days
pneumonia	≥ 60	Penicillin 50 000units/kg 6 hourly for three
		days if improved then oral amoxicillin 25
		mg/kg three times daily for a total of 8 days
		antibiotic treatment
Co-morbid conditions/pneumonia treatment
Pneumonia in	Signs and symptoms for severe	Cotrimoxazole prophylaxis on admission if
severely	/very severe pneumonia as above.	not acutely ill
malnourished child	PLUS signs and symptoms for any	Treatment for severe or very severe
	of the following:	pneumonia as above PLUS
	• Marasmus	Gentamicin (7.5 mg/kg IM/IV) once daily for
	• Kwashiorkor	7 days
	• <60% Weight for Height	➤If the child fails to improve within 48 hours,
		add Chloramphenicol (25 mg/kg IM/IV 8-
		hourly) for 5 days.
Known/suspected	2–6-month-old child with central	Continue first-line antibiotic ( such as
PcP	cyanosis	Chloramphenicol) as mixed infection with
	Hyper-expanded chest	bacteria occurs
	Fast breathing	Oral Cotrimoxazole: 120mg three times
	Chest X-ray changes, but chest	daily if less than 5 kg; 240 mg three times
	clear on auscultation	daily if 5 kg or more for 21 days
	Enlarged liver, spleen, lymph
	nodes
	HIV test positive in mother or child