<prompt> A 10 months old child weighing 5 kg and length 65 cm presents with cough and cold. He was found to have a respiratory rate of 48 per minute with no retraction, grunting or cyanosis. There is no history of convulsions. Which of the following is true about this child?No pneumonia, only cough and coldChild has pneumoniaSevere pneumoniaVery severe disease  <response>: Ans. a. No pneumonia, only cough and cold Ref: Ghai 8e p759Respiratory rate of 48 per minute with no retraction, grunting or cyanosis in a 10 months old child weighing 5 kg and length 65 cm with cough and cold without history of convulsions is suggestive of no pneumonia only cold and cough.Acute Respiratory Infection ARI PneumoniaNo Pneumonia: Cough or ColdPneumonia Not severeSevere PneumoniaVery Severe Pneumonia No chest indrawing, No fast breathingQManagement: No antibiotics necessary Treat symptomatically If cough 30 days, refer for assessment No chest indrawingQ Fast breathing presentQSignsQ: Chest indrawing Nasal flaring Grunting CyanosisManagement: Give first dose of referral antibiotic Ampicillin Gentamicin Refer urgently to hospital; Drugs of ChoiceQ- Benzyl Penicillin or Ampicillin or Chlorampheniciol for first 48 hours and then Procaine Penicillin or Ampicillin or Chiorampheniciol for next 3 days Antibiotics to be changed if there is no improvement after first 48 hoursSignsQ: Convulsions, abnormally sleepy or difficult to awake Stridor when calm Stopped feeding Wheezing Fever or low body temperature Severe malnutritionManagement: Give first dose of referral antibiotic Ampicillin GentamicinQ Refer urgently to hospital Drug of ChoiceQ - Chloramphenicol IM for first 48 hours and then oral chloramphenicol till total 10 days Antibiotics to be changed to IM Cloxacillin Gentamicin if there is no improvement after first 48 hoursAge groupRespiratory rate0-2 months60minute2-12 months50minute12 months-5years40minuteManagement: At home Give antibiotics- Drug of choice CotrimoxazoleQ Reassessment after 2 days 