Can the history of empiric antibiotic treatment for neonatal sepsis inform future global trials?

Abstract

Antimicrobial resistance is a major threat to the Sustainable Development Goal to reduce neonatal mortality to 12 per 1000 live births [1]. Current global rates are at 17 per 1000 live births with variation between <1 and 50 per 1000 live births [2]. There are many contributing factors limiting the success of reaching this target including preterm birth, intrapartum-related complications, and birth defects. However, one of the other leading causes of mortality is neonatal sepsis. Current World Health Organization (WHO) guidelines recommend using a combination of ampicillin (or penicillin) and gentamicin for the empiric treatment of neonatal sepsis [3].