Ampicillin + Gentamycin OR Ampicillin + Cefotaxime.

“Any child younger than 29 days with a fever should undergo a complete sepsis workup and be admitted for observation until culture results are obtained or the source of the fever is found and treated (SOR A). The most common bacterial organisms in this age group are group B Streptococcus and Escherichia coli. However, many other pathogens have been known to cause sepsis; therefore, broad empiric coverage with ampicillin and cefotaxime is recommended (SOR B). Gentamicin is commonly used, but should be used in combination with ampicillin. Vancomycin is not recommended as first-line treatment unless the child has evidence of a soft-tissue infection suspected to be methicillin resistant (SOR C). Ciprofloxacin and clindamycin are not indicated treatments in this case.

Ref:     Sur   DK,   Bukont   EL:   Evaluating   fever   of   unidentifiable   source   in   young   children.   Am   Fam   Physician 2007;75(12):1805-1811.     2)  Byington  CL,  Reynolds  CC,  Korgenski  K,  et  al:  Costs  and  infant  outcomes  after implementation of a care process model for febrile infants. Pediatrics 2012;130(1):e16-e24. 3) Pantell RH: Febrile infants: Aligning science, guidelines, and cost reduction with quality of individualized care. Pediatrics 2012;130(1):e199-e200.” ABFM

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