Remarks ■ The recommendation was based on three trials of 4307 infants aged 7–59 days from PHC clinics in Bangladesh, the Democratic Republic of the Congo, Ethiopia, India, Kenya, Malawi, Nigeria and Pakistan. ■ For the trial that compared oral amoxicillin for 7 days with procaine penicillin IM plus gentamicin IM for 7 days (1451 infants in the Democratic Republic of the Congo, Kenya and Nigeria), the evidence was judged as low certainty in the previous WHO guideline (2014) and very low certainty in this guideline. This was due to the serious imprecision for treatment failure (RR 0.86, 95% CI: 0.70 to 1.07) and the serious risk of bias (comparator arm had more protocol deviations, and different people administered antibiotics – parents in the intervention arm and study personnel in the comparator arm). ■ The GDG also considered evidence from one trial of 544 infants aged 7–59 days in Pakista n that compared oral amoxicillin versus placebo and from another trial of 2312 infants in Bangladesh, Ethiopia, India and Malawi that compared oral amoxicillin plus enhanced CHW community case management versus standard community case management. Both trials found little or no difference in the effect of oral amoxicillin based on low- or very low-certainty evidence. ■ The GDG recognized that there were limited data available on dose and duration of antibiotic therapy. Based on the trials included in the evidence review, the GDG considered that the following antibiotic dose should be used: oral amoxicillin 50 mg/kg every 12 hours for at least 7 days. ■ The GDG made a strong recommendation despite the limited evidence in non-hospital settings as they felt strongly about the importance of providing clear guidance for the management of infants with fast breathing. The GDG were able to use their knowledge and experience in best practice clinical management of fast breathing in young infants to make this recommendation by consensus.