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Early-onset neonatal sepsis — RACP Paediatrics MCQ

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ModerateNeonatologyEarly-onset neonatal sepsisRACP Paediatrics

A 14-hour-old term neonate is feeding poorly and has temperature 38.2°C, grunting and capillary refill 4 seconds. The mother had intrapartum fever and prolonged rupture of membranes. Blood glucose is normal. What is the most appropriate management?

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Correct answer: C — Obtain cultures and start empirical intravenous antibiotics immediately

The baby has clinical features and risk factors for early-onset sepsis, so cultures and empirical intravenous antibiotics should be started promptly. Lumbar puncture may be indicated when stable, but antibiotics should not be delayed in a shocked or unwell neonate. Poor feeding and respiratory signs in the first day of life should be treated as sepsis until proven otherwise.

Reference: Therapeutic Guidelines (eTG); RCH Sepsis guideline