Table 2. Differences between PSBI management guideline of Government of India (2014) and World Health Organization (2015).

SL no	Area	Specifics
		Government of India Guideline (2014)16	WHO Guideline (2015)*15
1	Danger signs to define PSBI	Eleven signs considered; the presence of one or more of these eleven signs defines PSBI.	Definition simplified by the presence of one or more of the only seven signs. Four signs were removed (nasal flaring, grunting, presence of pustules or big boil, blood in stool)
2	Simple fast breathing in 7–59 day old as a separate category and its treatment versus fast breathing in ≤ 6-day old infants	Fast breathing infants (≤59 days with or without other danger signs) considered PSBI and recommended to be treated as other PSBIs (Single daily dose of injectable gentamicin and twice-daily oral doses of amoxicillin for 7 days) if a referral is not possible	Young infant aged 7–59 days, presenting with only fast breathing and no other danger sign, defined as Pneumonia. Recommended treatment with twice-daily oral doses of amoxicillin for seven days and no injectable gentamicin on an outpatient basis. WHO guideline does not recommend referral to a hospital. Young infant aged less than or equal to six days presenting with only fast breathing and no other danger signs, defined as Severe Pneumonia, and managed as other PSBI conditions. Recommended referral to a hospital. If the family refuses to accept the referral advice, treat with single daily IM gentamicin and twice-daily oral amoxicillin for 7 days on an outpatient basis.
3	Dosage of oral amoxicillin	Recommended - 25mg/kg/dose twice daily	Recommended - 50mg/kg/dose twice daily for 7 days
4	Dosage of intramuscular injection gentamicin	5mg/kg/dose once daily for 7 days	5mg/kg/dose once daily for 7 days
5	Reclassification when referral is not possible	No such reclassification is mentioned	If a referral is not possible, WHO guideline recommends following the reclassification of PSBI cases based on the presence of one or more following danger signs- SEVERE PNEUMONIA: Please see above CLINICAL SEVERE INFECTION: at least one sign of severe infection, i.e. not feeding well on observation, temperature 38°C or more, temperature less than 35.5°C, severe chest in-drawing, movement only when stimulated. Recommended referral to a hospital. If the family refuses to accept the referral advice, treat with single daily IM gentamicin and twice-daily oral amoxicillin for 7 days on an outpatient basis. CRITICAL ILLNESS: In a young infant, presence of any of the following signs: convulsions, unable to feed at all, no movement on stimulation, unable to cry, bulging fontanels, cyanosis Recommended referral to a hospital. If the family refuses to accept the referral advice, treat with single daily intramuscular gentamicin and twice-daily injectable ampicillin until the referral is possible.

*The WHO guideline was used for the implementation study