Is prophylactic antibiotic treatment justified in neonates?

Infections are second leading cause of mortality preceded only by cardiovascular diseases.1 Neonates in particular are at a high-risk of developing bloodstream infections because of their immature immune system and mucosal surfaces.2,3 In neonates, sepsis has repeatedly been indicated to be an important cause of mortality, with preterm and very low birth weight (<1500g) infants being at the highest risk.3 Nosocomial bloodstream infections, are vital reasons for neonatal morbidity and mortality. According to a study 64% were caused due to grampositive organisms, 27% due to gram negative organisms and 8% due to fungi, the most common of the infectious agents being the coagulase negative staphylococci.4 The first microbial colonization in a newborn occurs during the passage through the birth canal and therefore the empiric treatment for early onset sepsis is based on the most common organisms detected at birth and that of late onset sepsis depends on presenting clinical signs.5