Most common broad-spectrum antimicrobial therapy indicated on NICU admission includes:

• A. Ampicillin and Gentamicin
• B. Ampicillin and Cefotaxime
• C. Penicillin G and Erythromycin
• D. Vancomycin and Gentamicin

Answer: (A)

In neonates admitted to the NICU, starting broad-spectrum empiric antibiotics targets the most common causes of early-onset sepsis, notably Group B Streptococcus, Listeria, and Gram-negative organisms like E. coli. The combination of ampicillin and gentamicin provides this coverage: ampicillin protects against GBS and Listeria, while gentamicin covers many Gram-negative bacteria. Together they offer effective initial therapy with a synergistic effect that helps kill a broad range of potential pathogens quickly, which is crucial while awaiting culture results. This regimen is widely used as the standard first-line empiric approach for suspected neonatal sepsis in the NICU. Other options either miss key organisms (for example, lacking Gram-negatives or Gram-positives coverage), or involve agents used for different scenarios (such as MRSA or meningitis-specific coverage) or have less favorable safety/efficacy data in this setting.