Reducing antibiotic exposure in early life: how low can we go?

The early days of life present clinicians with a paradox. On the one hand, sepsis remains a leading cause of morbidity and mortality among newborns, demanding rapid initiation of antibiotics. On the other hand, the majority of neonates who receive antibiotics for suspected early-onset sepsis (EOS) are ultimately not infected. This tension between the need to protect infants from life-threatening infection and the imperative to avoid unnecessary exposure lies at the heart of neonatal antibiotic stewardship.