Antibiotic resistance among neonatal pathogens is increasing
world wide. Reported rates of resistance depend partly on
the proportion of cases that are acquired in hospitals, where
multiresistant Pseudomonas, Klebsiella, Serratia, and other
enteric Gram negative bacilli are more common than in
community acquired sepsis.11 40 Gentamicin resistance among
Gram negative bacteria causing neonatal sepsis range from;
20% in Kenya;41 24% in India;14 43% in one study from
Pakistan42 and 78–84% in another;43 66% in Papua New
Guinea;40 and 77% in Guatemala.11 Despite high rates of
reported resistance, the combination of ampicillin and
gentamicin is still probably optimal first line treatment for
severe community acquired neonatal pneumonia in most
settings.