Table 1 Definition of clinical syndromes and currently recommended antibiotic treatment

Syndrome Definition Recommended antibiotic treatment* Sick young infants Any child <60 days old sick enough to warrant admission to hospital Gentamicin with either penicillin or ampicillin Meningitis/encephalopathy Neck stiffness, bulging fontanel, or impaired consciousness Penicillin with chloramphenicol Severe malnutrition Severe wasting or kwashiorkor Gentamicin with either penicillin or ampicillin Very severe pneumonia Respiratory distress plus one or more of prostration¶ cyanosis, or hypoxia** Chloramphenicol Severe pneumonia Respiratory distress Penicillin Mild pneumonia Tachypnoea plus a history of either cough or difficulty breathing Oral amoxicillin Skin or soft tissue infection Cellulitis, abscess, pyomyositis Cloxacillin

^* Parenteral unless otherwise indicated.

Blantyre coma score 2. ⁵

Weight for age z score <-4 by NCHS standards (Epi Info 2000, CDC, Atlanta, USA).

Lower chest wall indrawing or abnormally deep breathing.

^¶ Inability to sit unassisted if aged 1 year or inability to drink or breastfeed if aged <1 year. ⁶

^** SaO₂ <90% in air by pulse oximetry (Nellcor, USA).

50 breaths per minute if aged 60 days to 1 year; 40 breaths per minute if 1 year old. ¹