1. Start antibiotics immediately. Do not wait for the result of the blood culture.
2. Treat shock if it is present.
3. Transfer the patient urgently to hospital. Give oxygen during transport.
4. Look for an underlying cause and monitor for complications such as organ failure.

The fist choice of antibiotics is either:

• Benzyl penicillin 50 000 units/kg every 6 hours intravenously (or ampicillin 50 mg/kg every 6 hours intravenously) plus gentamicin 7.5 mg/kg daily (or amikacin 20 mg/kg daily), given slowly intravenously over 5 minutes.
• Ceftriaxone 80 mg/kg daily intramuscularly or by slow intravenous injection. This is very useful in a primary care facility before the child is transferred to hospital.