CSF: cerebrospinal fluid; GBS: group B Streptococcus; IAP: intrapartum antibiotic prophylaxis; LP: lumbar puncture.
* Adequate GBS IAP is defined as the administration of penicillin G, ampicillin, or cefazolin ≥4 hours before delivery. For details regarding indications for IAP, refer to related UpToDate content on prevention of GBS in pregnancy.
¶ Blood and CSF cultures should be obtained before starting empiric antibiotics. However, LP should not be performed if the procedure would compromise the neonate's condition. Antibiotic therapy should not be deferred because of procedure delays.
Δ For details regarding management with empiric antibiotics, refer to related UpToDate content on treatment of neonatal GBS and neonatal sepsis.
◊ For low-risk neonates who subsequently develop severe clinical instability or signs of severe sepsis (eg, shock), it is generally appropriate to perform laboratory evaluation for sepsis and administer empiric antibiotics, as for neonates at increased risk.