iajabmsIAJABMSIAJABMS2709-3298https://doi.org/10.47310/iajabms.2021.v02i02.003Bacteriological Profile and Antibiotic Sensitivity Pattern In Early Onset Sepsis and Late-Onset Sepsis and comparison of ampicillin gentamicin combination with regard to 3 rd generation cephalosporins for empirical treatment initiationPankajKatochBackground: Diagnosis of bloodstream infection in neonates is quite difficult due to varied symptoms, thus empirical therapy guided by knowledge of causative agents and their local antibiotic susceptibility profile is a critical step to improve therapeutic outcomes in such cases. So we planned to study the bacteriological profile and antibiotic susceptibility pattern in neonatal sepsis to compare the efficacy of ampicillin and gentamicin combination as compared to 3rd generation cephalosporin's so that empirical antibiotics treatment could be tailored to treat neonatal sepsis. Methods: It was a prospective observational study conducted throughout one and a half years from January 2015 to June 2016 in the Department of Paediatrics and Microbiology, Indira Gandhi Medical College and Hospital, Shimla (INDIA). Blood culture samples of neonates suspected of having EOS  or LOS were sent to the Microbiology department where they were inoculated into BACTEC TM Peds plus/F which was then inserted into the BD BACTEC fluorescent series instrument for incubation. The antibiotic sensitivity testing was done by disc diffusion as per CLSI guidelines. Zone sizes were measured and interpreted by BD PHOENIX AUTOMATED AST machine according to CLSI standards 2016. Results: Bacteria were isolated from 183 samples and 162 samples were negative out of the listed 345neonates.  These 183 neonates were enrolled as cases in the study. Out of 183 cases, 70 cases were inborn and 113 were outborn.  The positive blood culture isolation rate was 48.3% and 56.5% in inborn and outborn respectively. There were 102 males and 81 females in the study. The blood culture isolation rate was 53%. Bacteria were isolated from 37 samples of suspected EOS neonates with a  positive isolation rate of 48% and 146 samples of suspected LOS with a  positive culture isolation rate of 54.5%. Conclusion: The prevailing pattern of causative etiological agents and their sensitivity pattern is very important as it helps in the selection of specific and effective antibiotic(s) for treatment of the index case. It also helps to formulate an institutional policy regarding the selection of antibiotics at the time of admission in neonates admitted with suspected sepsis. This helps in preventing the misuse of antibiotics and the emergence of antibiotic resistance.