Neonates randomized to intervention Group(Antibiotic group)will receive the first line antibiotics (Piperacillin-Tazobactam and Amikacin) as per the unit policy for 72 hours. These neonates will also be monitored by performing sepsis screens and blood culture for development of sepsis.

Neonates randomized to 'No antibiotic group' will receive supportive treatment as per standard unit protocol. These neonates will be monitored by performing sepsis screens and blood culture for development of sepsis.

Neonatal Sepsis

Inj Piperacillin-Tazobactam 50 mg/Kg/dose 12 hourly IV X 3 days (6 doses) Inj Amikacin 15 mg/kg/dose 24 hourly IV X 3 days (3 doses)

Piperacillin-Tazobactam and Amikacin

Kalawati Saran children's Hospital, Lady Hardinge Medical College

Role of Antibiotics in Preventing Infection in Babies Born Through Meconium Stained Liquor

Role of Prophylactic Antibiotics in Preventing Neonatal Sepsis in Neonates Born Through Meconium Stained Amniotic Fluid - A Randomized Controlled Trial

Incidence of sepsis in first 28 days defined as -
SUSPECTED SEPSIS - Sepsis Screen > 2 parameters positive and/or
CONFIRMED SEPSIS - Sepsis Screen positive + Blood or CSF culture positive for bacteria.
Sepsis Screen
Total leukocyte count < 5000/mm3
Absolute neutrophil count < 1800/cu.mm.(Low counts as per Monroe chart for term neonates)
Immature/total neutrophil ratio > 0.2
Micro-ESR > 15mm in 1st hour
C Reactive Protein (CRP) > 1 mg/dl

Requirement of respiratory support
The mode of respiratory support viz. Supplemetal Oxygen therapy, CPAP, Mechanical ventilation, High Frequency ventilation
Duration of each kind of respiratory support required

Incidence of PPHN by Echocardiography, Pneumothorax by transillumination confirmed by chest x-ray, azotemia by Kidney function test panel

ototoxicity/hypoxia

Role of Antibiotics in Preventing Infection in Babies Born Through Meconium Stained Liquor

Effect of NAC on Sleep Apnea

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