Early-onset neonatal sepsis

A bacterial infection in a newborn that presents within the first 72 hours of life, most often caused by group B streptococcus, Escherichia coli, or Listeria. It requires prompt empirical antibiotic therapy before culture results are available.

ICD-10 P361 drug

Also known as: Early-onset sepsis (EOS), Early-onset neonatal bacterial infection, Suspected early-onset neonatal infection

Drugs used for this condition

AGentamicinFirst line · Aminoglycoside antibioticGentamicin is a first-line agent for empirical treatment of early-onset neonatal sepsis, but only as the mandatory second drug alongside a beta-lactam: NICE NG195 (2021) names benzylpenicillin with gentamicin as the first-choice regimen, and the AAP (2018) recommends ampicillin with an aminoglycoside. The combination covers the main pathogens (group B streptococcus, Escherichia coli, and Listeria), with gentamicin adding synergy against the beta-lactam's targets. Gentamicin here is co-first-line rather than reserve, and is given once daily (Cochrane, Rao 2016). Cochrane systematic reviews (2021, 2016) support this regimen and the choice of combination.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit