What is the first step in managing sepsis in a neonate?

The first step in managing sepsis in a neonate is starting broad-spectrum antibiotics. In the context of sepsis, early identification and intervention are crucial, and antibiotic therapy is a central component of this management strategy. Neonates are particularly vulnerable to infections, and sepsis can progress rapidly, making timely antibiotic administration essential.

Broad-spectrum antibiotics are chosen because they can cover a wide range of potential pathogens, including Gram-positive and Gram-negative bacteria, common in neonatal sepsis. This empirical approach allows for immediate treatment while laboratory results are pending, thus reducing the risk of severe morbidity and mortality associated with sepsis.

Other interventions, such as controlling blood pressure, may be necessary later in the treatment as sepsis can lead to hemodynamic instability. Lumbar puncture may be indicated in certain cases to assess for meningitis but is not an immediate priority. Administering opioids is not appropriate at this initial stage, as it does not address the underlying infection and can complicate the clinical picture by masking symptoms.