Transient Tachypnea of the Newborn Medication

Updated: Dec 23, 2020
  • Author: Siva Subramanian, MD, FAAP; Chief Editor: Ted Rosenkrantz, MD  more...
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Medication Summary

The use of medications in transient tachypnea of the newborn (TTN) is minimal. It is difficult to rule out sepsis or pneumonia clinically, in the presence of signs of respiratory distress, especially in the absence of risk factors for infection in the infant. Therefore, empiric antibiotics are often used for 48 hours after birth, until sepsis has been ruled out.

Studies suggest that routine use of empirical antibiotics may not be warranted in late preterm and full-term infants with transient tachypnea of the newborn in the absence of specific infectious risk factors and a negative C-reactive protein. [32] Infants who received antibiotics stayed longer in the hospital. [33, 34]

Diuretics [28] and inhaled corticosteroids [35] have not been shown to be beneficial.



Class Summary

These agents are used when sepsis is clinically suggested. Antibiotics generally consist of a penicillin (usually ampicillin) and an aminoglycoside (usually gentamicin). Choices are based on local flora and antibiotic sensitivities. Dosage amounts and intervals are based on postmenstrual age (PMA), measured in weeks, and postnatal age, measured in days.

Ampicillin (Omnipen-N)

A penicillin antibiotic with activity against gram-positive and some gram-negative bacteria. Ampicillin binds to penicillin-binding proteins (PBPs), inhibiting bacterial cell wall growth.


Provides gram-negative aerobic coverage. Gentamicin also provides synergistic activity with penicillins against gram-positive bacteria including group B Streptococcus and Enterococcus. Gentamicin inhibits protein synthesis by irreversibly binding to bacterial 30S and 50S ribosomes.

Given as IV infusion by syringe pump over 30 min. Administer as separate infusion from penicillin-containing compounds.

IM injection is associated with variable absorption, especially in VLBW infants.