🧒 PaediatricsInfectious / NeonatalStudentInternResident

Neonatal Sepsis

Also known as: neonatal sepsis · newborn infection · sepsis neonatorum

A serious bloodstream infection in the first 28 days of life. The signs are non-specific — treat early and empirically; delay is dangerous.

Source · Reviewed 2026-08-15 · v1.0— AI-assisted draft — verify against the cited guideline / unit protocol before clinical use.

⚕️ Education only — not medical advice. Verify against the latest official guideline and your local protocol; confirm every drug dose against the cited source before clinical use.

Who gets it

Newborns; risk with prematurity, prolonged rupture of membranes, maternal fever/GBS, unclean delivery and low birth weight. Early-onset (<72 h, often maternal) vs late-onset (>72 h).

Red flags — escalate / refer

Poor feeding, lethargy, temperature instability, respiratory distress/apnoea, poor perfusion, seizures, or a bulging fontanelle → sepsis until proven otherwise: act now.

Work-up / diagnosis

1Do a sepsis screen and blood culture, and consider a lumbar puncture; check glucose and CBC/CRP.
2Do NOT delay antibiotics for the work-up.
3Assess maternal risk factors.

Management — overview

Start empirical IV antibiotics immediately after taking cultures (per unit protocol) — every hour counts.
Supportive care: airway/breathing/circulation, maintain glucose and temperature, and treat shock.
Narrow antibiotics on culture/sensitivity; treat for the appropriate duration (longer for meningitis).
Involve neonatology; prevent with intrapartum GBS prophylaxis and clean delivery.

In-depthFull dosing & advanced protocol

Drug dosing

Empirical IV antibiotics

Start immediately after cultures

Adult dose: Per unit protocol (commonly ampicillin + gentamicin for early-onset; broaden for late/hospital-acquired)
Route: Intravenous

Caution: Dose by weight/gestation; start within the hour.

ICMRICMR Treatment Guidelines for Antimicrobial Use in Common Syndromes (2019) ↗

Supportive neonatal care

Stabilisation

Adult dose: Maintain glucose/temperature; circulatory support
Route: —

IAPIndian Academy of Pediatrics (IAP) — guidelines ↗

Onset, meningitis & prevention

Early- vs late-onset sepsis differ in organisms and empirical cover.
Treat meningitis for a longer duration with CSF-penetrating agents.
Prevention: intrapartum GBS prophylaxis, clean delivery and hand hygiene.

IAPIndian Academy of Pediatrics (IAP) — guidelines ↗

References

Guidelines change. If something here is out of date, tell us — we keep these current.

🚩 Report outdated / suggest update

More protocols

Acute Gastroenteritis — ORS & ZincAcute diarrhoea (± vomiting), usually a self-limiting viral illness. The danger is dehydration; low-osmolarity ORS plus zinc are the evidence-based core of treatment.Febrile SeizureA seizure with fever in a young child (6 months–5 years) without CNS infection or another cause. It is usually benign, but exclude serious causes and support the family.BronchiolitisA viral lower-respiratory infection of infants (usually under 2 years, most often RSV) — coryza followed by wheeze, fine crackles and feeding difficulty. Management is supportive.

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👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Empirical IV antibiotics

Supportive neonatal care

📈 Onset, meningitis & prevention

📚 References

More protocols

👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Empirical IV antibiotics

Supportive neonatal care

📈 Onset, meningitis & prevention

📚 References

More protocols

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Onset, meningitis & prevention

References

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Onset, meningitis & prevention

References