Medication Therapy for Early-Onset Neonatal Sepsis.

S sepsis is a common cause of morbidity and mortality in neonates. In a population-based surveillance study1 from 2005 to 2008, researchers estimated that 3300 cases of early-onset sepsis (EOS) occur in the United States each year, with 390 of these cases resulting in death. The risk is highest in preterm neonates, which account for 1570 of the 3300 cases and 360 deaths.1 Despite its prevalence, though, identifying patients with sepsis, determining causative organisms, and establishing a length of treatment remain a challenge for health care practitioners. Sepsis in neonates can be classified as either early onset or late onset. No single definition for EOS exists, but most often it is described as infection of the bloodstream or meninges that occurs within the first 6 days of life.2 The most commonly implicated organisms are group B streptococci (GBS) and Escherichia coli, which are most often acquired via vertical transmission from the mother during the intrapartum period.1 In general, GBS is most prevalent in term neonates, whereas E coli is more attributable to EOS in preterm and low-birth-weight infants.1,3 Late-onset sepsis occurs after the first week of life and is associated with nosocomial organisms acquired via horizontal transmission. Thus, awareness of the timing of the onset of sepsis can be helpful in determining initial empiric antimicrobial therapy for the neonate.