Muller-Pebody et al1 provide a description of antibiotic sensitivitiesdetected in a large number of bacterial isolates from neonatal blood cultures. The Health Protection Agency's voluntary surveillance scheme captures microbiology results from 90% of the laboratories in England and Wales, a strength of this study. The study defined early-onset sepsis as a positive blood culture in the first 48 h of life and late-onset sepsis as a positive blood culture obtained between days 2 and 28 of life. From January 2006 to March 2008, 1516 bacteria were isolated from neonates in the first 48 h of life and 3482 bacteria were isolated from neonates 2–28 days of age.

Gram-positive organisms composed 82.2% of early-onset sepsis isolates and 80.7% of late-onset sepsis isolates. Nearly all (94%) of the early-onset isolates were sensitive to an antibiotic regimen of penicillin+gentamicin and 100% were sensitive to the combination of amoxicillin+cefotaxime. For late-onset isolates, 93% were sensitive to amoxicillin+cefotaxime and 96% were sensitive to a regimen of amoxicillin+gentamicin. Excluding coagulase negative staphylococci (CoNS) from the analysis, the authors continued to observed high rates of sensitivity (95–97%) of the remaining isolates to relatively narrow spectrum antibiotic regimens including penicillin+gentamicin and flucloxacillin+gentamicin. The …