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International Journal of Pediatrics
Volume 2011 (2011), Article ID 712150, 9 pages
Review Article

Choice and Duration of Antimicrobial Therapy for Neonatal Sepsis and Meningitis

1Division of Neonatology, Department of Pediatrics, University of Calgary, Calgary, AB, Canada T2N 1N4
2Institute for Maternal and Child Health, University of Calgary, Calgary, AB, Canada T2N 4N1

Received 30 June 2011; Accepted 4 October 2011

Academic Editor: N. B. Mathur

Copyright © 2011 Sindhu Sivanandan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Neonatal sepsis is associated with increased mortality and morbidity including neurodevelopmental impairment and prolonged hospital stay. Signs and symptoms of sepsis are nonspecific, and empiric antimicrobial therapy is promptly initiated after obtaining appropriate cultures. However, many preterm and low birth weight infants who do not have infection receive antimicrobial agents during hospital stay. Prolonged and unnecessary use of antimicrobial agents is associated with deleterious effects on the host and the environment. Traditionally, the choice of antimicrobial agents is based on the local policy, and the duration of therapy is decided by the treating physician based on clinical symptoms and blood culture results. In this paper, we discuss briefly the causative organism of neonatal sepsis in both the developed and developing countries. We review the evidence for appropriate choice of empiric antimicrobial agents and optimal duration of therapy in neonates with suspected sepsis, culture-proven sepsis, and meningitis. Moreover, there is significant similarity between the causative organisms for early- and late-onset sepsis in developing countries. The choice of antibiotic described in this paper may be more applicable in developed countries.