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Neonatal Sepsis — RACP Paediatrics MCQ

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ModerateInfectious DiseaseNeonatal SepsisRACP Paediatrics

A 3-week-old neonate presents with fever (38.5°C), poor feeding, and irritability. He was born at term with no complications. The mother is GBS-negative. What is the most appropriate initial management?

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Correct answer: E — Blood cultures, urine, LP, and commence IV ampicillin and gentamicin

A febrile neonate (<28 days) requires a full septic workup (blood cultures, urine culture, lumbar puncture) and empirical IV antibiotics. The combination of ampicillin (for Listeria and enterococcal cover) and gentamicin (for Gram-negative cover) is standard empirical therapy in this age group. Ceftriaxone does not cover Listeria and should not be used alone.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Neonatal Sepsis