Neonatal infection: antibiotics for prevention and treatment

Be aware that, although minor conjunctivitis with encrusted eyelids is common and often benign, a purulent discharge may indicate a serious infection (for example, with chlamydia or gonococcus). [2012]

In babies with a purulent eye discharge take swab samples urgently for microbiological investigation, using methods that can detect chlamydia and gonococcus. Start systemic antibiotic treatment for possible gonococcal infection while waiting for the swab microbiology results. [2012]

In babies with clinical signs of umbilical infection, such as a purulent discharge or signs of periumbilical cellulitis (for example, redness, increased skin warmth or swelling):

• perform a blood culture and

• take a swab sample for microscopy and culture and

• start antibiotic treatment with intravenous flucloxacillin and gentamicin (for starting dose of gentamicin, see recommendation 1.20.3 in the section on choice and dosage of intravenous antibiotics for suspected early-onset neonatal infection).
  
  If the microbiology results show that the infection is not caused by a Gram-negative bacterium, stop the gentamicin. [2012]