Spectrum: Local Antimicrobial Stewardship, for Yangon Children's Hospital

Neonatal Sepsis

Definition

Neonatal sepsis is a clinical syndrome of bacteraemia with systemic signs and symptoms of infection in the first four weeks of life

Diagnosis

Physical examination may be unremarkable

Investigations

Culture

Send a blood culture (and CSF and/or urine) before starting antibiotics

Important Notes

Selection of empirical antibiotics in suspected sepsis should be based on postnatal age at the onset of the disease

i.e. EOS vs. LOS, previous antibiotic therapy, local antibiogram

There is no role for prophylactic antibiotics

Avoid using broad-spectrum antibiotics first line and keep duration as short as possible

Early Onset Sepsis (EOS)

Presents within the first 72 hours of life

Late Onset Sepsis (LOS)

  • Usually presents after 72 hours of age on days 4-90 of life (may be nosocomial or community acquired)

    • 4-28 days: Late Onset Sepsis (LOS)
    • 29-90 days: Late Late Onset Sepsis (LLOS)

  • Gram negative nosocomial sepsis often presents with a more rapid deterioration and is commonly associated with shock and coagulopathy