Neonatal infections in developing countries

The World Health Organization (WHO) recommends ampicillin (or penicillin) plus gentamicin for empirical treatment of suspected sepsis in neonates and infants <2 months old in developing countries. A systematic review of 19 studies from 13 countries found that Staphylococcus aureus and Gram-negative bacilli (mostly Escherichia coli and Klebsiella species) caused more than half of the >4000 positive blood cultures.[1] The WHO regimen covered only 57% of isolates, but third-generation cephalosporins that covered 56% fared no better. The authors called for revised recommendations.[1] An accompanying editorial subtitled ‘The War on Error’ said there was as much chance of combating antibiotic resistance by escalation as of winning the war on terror.[2] The editorial writers advocated de-escalation of broad-spectrum antibiotic use, improved diagnostics and prevention of neonatal infections.[2]

Reviewer: David Isaacs,