A 2-day-old neonate born to a GBS-positive mother who did not receive intrapartum antibiotic prophylaxis develops respiratory distress, hypotension, and a temperature of 39.2°C. Blood culture grows Group B Streptococcus. What is the treatment of choice?

• A Vancomycin + meropenem
• B Ampicillin + gentamicin ✓
• C Cefotaxime alone
• D Penicillin G + gentamicin for synergy

Explanation

Ampicillin combined with an aminoglycoside (gentamicin) is the empiric and definitive treatment of choice for early-onset neonatal sepsis, including GBS. Ampicillin provides GBS coverage while the combination also covers Gram-negative organisms and provides synergistic bactericidal activity. Vancomycin is reserved for MRSA or resistant organisms. Penicillin alone (without gentamicin) can be used for confirmed GBS once culture results are available, but ampicillin + gentamicin is the standard empiric regimen.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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