Neonatal Septicaemia in Uganda: Overview and Treatment

What is Neonatal Septicaemia?
Neonatal septicaemia is a bloodstream infection occurring in newborn babies. The bacteria that cause it are similar to those causing neonatal pneumonia and meningitis. It is a serious condition requiring urgent hospital care.

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Management

Supportive Care:

  • Keep the baby warm
  • For high fever, control the environment by undressing the baby; avoid using paracetamol
  • Prevent low blood sugar by breastfeeding if possible, or using a feeding tube (NGT) or intravenous glucose
  • Ensure hydration and nutrition
  • Provide oxygen if the oxygen saturation is below 90%

First Line Treatment:

  • Ampicillin 50 mg/kg IV every 6 hours
  • Gentamicin 5 mg/kg IV every 24 hours
  • Duration: 10 days

If there is risk of Staphylococcus infection (e.g., infected umbilical stump or multiple skin pustules):

  • Give cloxacillin 50 mg/kg IV or IM every 6 hours
  • Continue gentamicin 5-7 mg/kg every 24 hours
  • Clean infected umbilicus and pustules, apply gentian violet

If no improvement after 48-72 hours:

  • Change ampicillin to ceftriaxone 100 mg/kg once daily
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