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. 2019 May 28:1–7. doi: 10.1016/B978-0-323-55512-8.00001-6

TABLE 1.1.

Revised WHO Classification and Treatment of Childhood Pneumonia at Health Facilities

  • 1.

    Children with fast-breathing pneumonia with no chest in-drawing or general danger signs should be treated with oral amoxicillin: at least 40 mg/kg/dose twice daily (80 mg/kg/day) for 5 days. In areas with low HIV prevalence, give amoxicillin for 3 days. Children with fast-breathing pneumonia who fail on first-line treatment with amoxicillin should have the option of referral to a facility where there is appropriate second-line treatment.

  • 2.

    Children age 2–59 months with chest in-drawing pneumonia should be treated with oral amoxicillin: at least 40 mg/kg/dose twice daily for 5 days.

  • 3.

    Children aged 2–59 months with severe pneumonia should be treated with parenteral ampicillin (or penicillin) and gentamicin as a first-line treatment. Ampicillin: 50 mg/kg, or benzyl penicillin: 50,000 units per kg IM/IV every 6 hours for at least 5 days. Gentamicin: 7.5 mg/kg IM/IV once a day for at least 5 days. Ceftriaxone should be used as a second-line treatment in children with severe pneumonia having failed on the first-line treatment.

  • 4.

    Ampicillin (or penicillin when ampicillin is not available) plus gentamicin or ceftriaxone are recommended as a first-line antibiotic regimen for HIV-infected and HIV-exposed infants and for children under 5 years of age with chest in-drawing pneumonia or severe pneumonia. For HIV-infected and HIV-exposed infants and for children with chest in-drawing pneumonia or severe pneumonia who do not respond to treatment with ampicillin or penicillin plus gentamicin, ceftriaxone alone is recommended for use as second-line treatment.

  • 5.

    Empiric cotrimoxazole treatment for suspected Pneumocystis jirovecii (previously P. carinii) pneumonia is recommended as an additional treatment for HIV-infected and HIV-exposed infants aged from 2 months up to 1 year with chest in-drawing or severe pneumonia. Empirical cotrimoxazole treatment for P. jirovecii pneumonia is not recommended for HIV-infected and HIV-exposed children over 1 year of age with chest in-drawing or severe pneumonia.