Neonatal Sepsis Management
A newborn with infection does not look obviously infected. They feed poorly, feel cool, breathe faster or simply seem not quite right, and a parent often notices before anybody else. Because deterioration can be rapid, treatment starts on suspicion rather than on proof.
- Antibiotics started on suspicion, not on proof
- Blood cultures taken before antibiotics
- Treatment reviewed at 48 hours
- Parents' instincts taken seriously
Stay
5 to 10 days typically
Duration
Antibiotics started within the hour
Anaesthesia
Not applicable
About Neonatal Sepsis Management
Newborn infection is treated urgently because the margin is small. Blood cultures and other samples are taken, antibiotics started immediately, and the baby monitored closely. At around 48 hours the cultures and the baby's condition are reviewed together: if the cultures are clear and the baby is well, antibiotics are stopped. That combination of prompt starting and prompt stopping is what good practice looks like.
- Started on suspicion because waiting for proof costs too much
- Cultures are taken first so the result is not lost
- Stopped at 48 hours if cultures are clear and the baby is well
- A parent saying the baby is not right is taken seriously
Before you read on
Everything here is general information about neonatal sepsis management. Whether it suits you, and how it would be done in your case, is a decision for your doctor after examining you.
Your consultant's instructions always take precedence over anything written on this page.
When is it recommended?
Situations in which a doctor may suggest neonatal sepsis management.
- Newborns with poor feeding, lethargy or temperature instability
- Babies born after prolonged rupture of membranes
- Babies whose mothers had fever or infection in labour
- Preterm babies, who are at higher risk
- Any newborn who deteriorates unexpectedly
Procedure details
The usual sequence, from first consultation through to follow-up.
Assessment
A full examination, with attention to breathing, temperature, colour, tone and feeding. The parent's account matters here.
Samples
Blood cultures, blood counts and inflammatory markers are taken. Other samples are collected where indicated.
Antibiotics
Started immediately after cultures are taken, without waiting for results, because delay is what causes harm.
Review at 48 hours
Cultures and the baby's progress are reviewed together. Antibiotics are stopped if the cultures are clear and the baby is well.
How to prepare
What to sort out before you come in.
- This is unplanned and urgent, so there is nothing to prepare
- Tell the team about fever, infection or prolonged rupture of membranes during labour
- Mention any previous baby with a newborn infection
- Say if you feel the baby is not behaving normally, as that is genuinely useful information
Recovery
What to expect afterwards, and roughly when.
- A course of antibiotics is usually five to seven days if infection is confirmed
- Feeding usually improves within a day or two of starting treatment
- The intravenous line stays in for the duration of the course
- Most babies recover fully with no lasting effect
- A follow-up is arranged, particularly for preterm babies
Why choose Humayun for suspected newborn infection
In newborn sepsis the whole outcome rests on how quickly antibiotics are started.
- Antibiotics started within the hour rather than after results, because delay is what causes harm
- Cultures taken before antibiotics, so the organism can still be identified
- Antibiotics stopped promptly at 48 hours when cultures are clear, rather than continued out of habit
- Neonatal intensive care in the same unit if the baby deteriorates
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More in Neonatal Services
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Low Birth Weight Newborn Care
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Neonatal Respiratory Support
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Neonatal Jaundice Management
Assessment and treatment of newborn jaundice, from measuring the level to phototherapy and, rarely, exchange transfusion.
Newborn Feeding Support
Practical help with breastfeeding, expressing and tube feeding, so babies feed well before they go home.
High-Risk Newborn Monitoring
Close observation of babies at higher risk of problems, so complications are found before they become obvious.