Among neonates, which organisms are common causes of meningitis and how should they be treated?

In neonates, the most common organisms responsible for meningitis are Group B Streptococcus and Escherichia coli. These pathogens are significant contributors to neonatal infections given their prevalence in the vaginal flora, where they can be transmitted during childbirth.

The treatment for meningitis caused by these organisms in neonates is typically a combination of gentamicin and ampicillin. This regimen is effective because ampicillin provides coverage against Group B Streptococcus and Listeria monocytogenes, while gentamicin covers E. coli, which is crucial given the potential severity of infections caused by these bacteria in young infants.

This dual therapy is important as it ensures broad coverage against the common pathogens associated with early-onset meningitis in neonates, while also addressing the risk of antibiotic resistance and improving treatment outcomes. Additionally, the specific combination of these antibiotics allows for effective treatment while minimizing the risk of serious side effects, making it a standard approach in neonatal care.