In addition to fluid resuscitation and supportive care, a common antibiotic regimen in infants with suspected sepsis is  a beta-lactam antibiotic (usually ampicillin) in combination with an aminoglycoside (usually gentamicin) or a third-generation cephalosporin (usually cefotaxime—ceftriaxone is generally avoided in neonates due to the theoretical risk of kernicterus.) The organisms which are targeted are species that predominate in the female genitourinary tract and to which neonates are especially vulnerable to, specifically Group B Streptococcus, Escherichia coli, and Listeria monocytogenes (This is the main rationale for using ampicillin versus other beta-lactams.) Of course, neonates are also vulnerable to other common pathogens that can cause meningitis and bacteremia such as Streptococcus pneumoniae and Neisseria meningitidis. Although uncommon, if anaerobic species are suspected (such as in cases where necrotizing enterocolitis or intestinal perforation is a concern, clindamycin is often added.Granulocyte-macrophage colony stimulating factor (GM-CSF) is sometimes used in neonatal sepsis. However, a 2009 study found that GM-CSF corrects neutropenia if present but it has no effect on reducing sepsis or improving surviva. Antibiotic Overtreatment
In cases of suspected Early Onset Sepsis (EOS) one of the treatments is empirical antibiotics. The strategy of clinicians utilizing antibiotics as a course of treatment for EOS has resulted in the overtreatment of antibiotics to infants suspected of having signs of EOS. There are several consequences to the overtreatment of antibiotics in newborns including "microbiome alterations, which are linked to the development of asthma, food allergies, and childhood obesity".
The study used measures of health available at the time of birth such as highest intrapartum maternal temperature, rupture of membranes, whether or not the mother has group b streptococcus, and if the mother was given any intrapartum antibiotics. Intrapartum prophylaxis is a strategy for "the secondary prevention of early-onset GBS disease in newborns" that could lead to EOS. The Sepsis Risk Calculator (SRS) is meant to be another clinical measure that physicians can use in conjunction with physical examination.An evaluation of the SRS was done in an independent retrospective cohort study by doctors at a University Hospital in Greece. The study aimed to "compare our clinical practice based on risk-factor guidance with that projected through the application of the SRC". The study incorporated 2,084 infants and found that "The adoption of SRC would have significantly reduced antibiotic usage; however, a significant portion of cases with clinical EOS would have been missed". Another study evaluated the impact of Integrating the SRC into the electronic health record in order to "improve compliance and accuracy through automation". The study concluded that the integration of the EOS into the electronic health record system "significantly increased calculator accuracy". References


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