Guideline Summary for Acute Cough in Infants Without Evidence of Pneumonia

Diagnostic Criteria

• A symptom duration of only 3 days with mild findings does not satisfy criteria for pneumonia that would require antimicrobial therapy. 1

Imaging Recommendations

• Chest radiography is required to confirm community‑acquired pneumonia before initiating antibiotics. 1
• Routine chest X‑ray is not indicated for infants with mild cough and rhonchi who lack respiratory distress. 1

Initial Management

• Provide supportive care only—adequate hydration, humidified air, and nasal suction as needed—without prescribing antibiotics, cough suppressants, or decongestants. 1

Criteria for Re‑evaluation

• If the infant shows no clinical improvement after 48–72 hours, prompt reassessment is warranted. 1

Antibiotic Therapy (if pneumonia is confirmed)

• For a fully immunized infant in regions with low penicillin resistance, empiric intravenous ampicillin or penicillin G is the first‑line regimen. 1