What is the first-line treatment for bacterial meningitis in neonates?

The first-line treatment for bacterial meningitis in neonates involves the use of ampicillin and cefotaxime. This combination provides broad-spectrum coverage against the most common pathogens responsible for meningitis in this age group, which typically includes group B Streptococcus and Escherichia coli, as well as Listeria monocytogenes in some cases.

Ampicillin effectively targets Listeria and some strains of Streptococcus, while cefotaxime is crucial for covering gram-negative organisms, including E. coli. The use of both antibiotics ensures a comprehensive approach that addresses the predominant bacterial causes of meningitis in newborns, thereby reducing the risk of complications and mortality associated with this serious condition.

In contrast, other treatments listed would not be appropriate as initial therapy for bacterial meningitis in neonates. Ceftriaxone, while effective for many bacterial infections, is not typically used in neonates due to the potential risk of kernicterus from displacing bilirubin. Acyclovir is indicated for viral infections like herpes simplex virus and is not suitable for bacterial meningitis. Gentamicin alone would provide insufficient coverage against the range of bacteria involved, particularly Listeria. Therefore, the use of ampicillin and cefot