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Early-Onset Neonatal Sepsis — RACP Paediatrics MCQ

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ModerateNeonatologyEarly-Onset Neonatal SepsisRACP Paediatrics

A term newborn develops respiratory distress within the first hour of life. The mother had no antenatal care and no GBS screening. Chest X-ray shows bilateral diffuse ground-glass opacification with air bronchograms. Blood cultures are taken. What is the most appropriate empirical antibiotic regimen?

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Correct answer: B — IV benzylpenicillin and gentamicin

Early-onset neonatal sepsis (within the first 72 hours) is most commonly caused by Group B Streptococcus (GBS) and E. coli. The standard empirical regimen in Australasia is IV benzylpenicillin (for GBS cover) and IV gentamicin (for Gram-negative cover). Amoxicillin/ampicillin and gentamicin is an acceptable alternative. Ceftriaxone is avoided in neonates due to bilirubin displacement and calcium-related complications.

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