A 36-hour-old neonate born to a GBS-positive mother who received intrapartum penicillin less than 4 hours before delivery develops respiratory distress and hypotension. Blood culture is sent. The IMMEDIATE empirical antibiotic regimen should be:

• A Vancomycin + cefepime
• B Meropenem + amikacin
• C Ampicillin + gentamicin ✓
• D Cefotaxime alone

Explanation

Empirical therapy for early-onset neonatal sepsis is ampicillin (covers GBS and Listeria) plus gentamicin (synergy against GBS, covers gram-negatives especially E. coli). This combination remains the standard of care per AAP/NNF guidelines. Intrapartum prophylaxis <4 hours before delivery is considered inadequate, so GBS sepsis is still a possibility. Vancomycin-based regimens are reserved for late-onset sepsis or MRSA risk. Meropenem is used for MDR gram-negative organisms.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.