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This guideline, developed by a panel of international experts and informed by a thorough review of existing evidence, provides recommendations on the use of antibiotics for neonates and young infants (0–59 days old) with PSBI in order to reduce young infant mortality rates. This guideline is intended for use in resource-limited settings in situations when families do not accept or cannot access referral. It seeks to provide programmatic guidance on the role of community health workers (CHWs) and home visits in identifying signs of serious infections in neonates and young infants. It also seeks to provide clinical guidance on the simplest antibiotic regimens that are both safe and effective for outpatient treatment of clinical severe infections and fast breathing (pneumonia) in children 0–59 days old.

This guideline will not replace the WHO-recommended inpatient management as the preferred treatment option for young infants who have clinical severe infection or critical illness. Close follow-up is essential for young infants managed on an outpatient basis where referral is not possible.

This guideline will help health care providers make appropriate management decisions about sick young infants whose families cannot access referral care. They will also guide national policy-makers in health ministries, programme managers, and development partners and will inform revisions to current WHO training and reference materials such as the Integrated Management of Childhood Illness (IMCI) Chart Booklet (3) and the Pocket Book of Hospital Care for Children: guidelines for the management of common illnesses (4).