Neonatal sepsis causes significant morbidity and mortality, especially in preterm infants. Clinicians are compelled to treat with empiric antibiotics at the first signs of suspected sepsis. Broad-spectrum antibiotics and prolonged treatment with empiric antibiotics are associated with adverse outcomes. Most common neonatal pathogens are susceptible to narrow-spectrum antibiotics. The choice of antibiotic and duration of empiric treatment are strongly associated with center-based risk factors. Clinicians should treat with short courses of narrow-spectrum antibiotics whenever possible, choosing the antibiotics and treatment duration to balance the risks of potentially untreated sepsis against the adverse effects of treatment in infants with sterile cultures.
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