ReviewFrontiers in pediatrics2018
Culture-Negative Early-Onset Neonatal Sepsis - At the Crossroad Between Efficient Sepsis Care and Antimicrobial Stewardship.
Review in Frontiers in pediatrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05274776 (Safely Reduce Newborn Antibiotic Exposure With the Early-onset Sepsis Calculator), which is not on this map. Cited by 148 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Safely Reduce Newborn Antibiotic Exposure With the Early-onset Sepsis Calculator: a Cluster Randomized Study (EOS Calculator RCT)
Who cites it
148 citing papers in PubMed, 4 syntheses or guidelines pooled it, 280 citations in OpenAlex.
- A systematic review of Perinatal Antibiotic Stewardship - where we are, where to go?Journal of perinatology : official journal of the California Perinatal Association · 2025Pooled it
- Shorter versus longer duration antibiotic regimens for treatment of suspected neonatal sepsis.The Cochrane database of systematic reviews · 2024Pooled it
- A meta-analysis of the association between inflammatory cytokine polymorphism and neonatal sepsis.PloS one · 2024Pooled it
- Antibiotic regimens for early-onset neonatal sepsis.The Cochrane database of systematic reviews · 2021Pooled it
- Aberrant Growth in 5-Year-Old Children After Antibiotics in the First Week of Life.Acta paediatrica (Oslo, Norway : 1992) · 2026Trial
- Acute kidney injury and subsequent risk of late-onset infection among extremely low gestational age newborns.Journal of perinatology : official journal of the California Perinatal Association · 2025Trial
- C-reactive protein- and clinical symptoms-guided strategy in term neonates with early-onset sepsis reduced antibiotic use and hospital stay: a quality improvement initiative.BMC pediatrics · 2020Trial
- Serum Soluble Programmed Death Ligand-1 (sPD-L1) as a Diagnostic Marker in Neonatal Sepsis: Correspondence-2.Indian journal of pediatrics · 2026Article
- Risk assessment of early-onset sepsis in extremely preterm infants: implications for antibiotic stewardship.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Neonatal sepsis definitions for randomised-controlled trials: challenges and approaches.International journal of epidemiology · 2026Article
- Neonatal Bloodstream Infections: A Narrative Review on Diagnostic and Therapeutic Challenges and Prospects in Developing Countries.Health science reports · 2026Article
- Impact of Drug Elution on Infectious Outcomes after Ductal Stenting in Newborns.Pediatric cardiology · 2026Observational
- Delineating the risk factors, sources of acquisition and clinical outcomes in neonates colonised with multidrug-resistant bacteria: the NeoCol study.Nature communications · 2026Article
- Prolonged empirical antibiotic therapy despite negative blood cultures in neonates: a retrospective stewardship-oriented analysis.BMC pediatrics · 2026Article
- Article
- A comparison between early onset sepsis (EOS) risk calculator and modified new protocol in a newborn ≥ 35 weeks: a simulation study.Italian journal of pediatrics · 2026Observational
- Aligning neonatal sepsis triage diagnostics with WHO target product profiles in low- and middle-income countries.BMJ global health · 2026Review
- Diagnostic challenges and Gram-negative pathogen dominance in early- and late-onset neonatal infection in Manila, Philippines.Nature communications · 2026Article
- Review
- Early-Onset Neonatal Infection and Cerebral Palsy.JAMA network open · 2026Article
88 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 5 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Sepsis is a leading cause of mortality and morbidity in neonates. Presenting clinical symptoms are unspecific. Sensitivity and positive predictive value of biomarkers at onset of symptoms are suboptimal. Clinical suspicion therefore frequently leads to empirical antibiotic therapy in uninfected infants. The incidence of culture confirmed early-onset sepsis is rather low, around 0.4-0.8/1000 term infants in high-income countries. Six to 16 times more infants receive therapy for culture-negative sepsis in the absence of a positive blood culture. Thus, culture-negative sepsis contributes to high antibiotic consumption in neonatal units. Antibiotics may be life-saving for the few infants who are truly infected. However, overuse of broad-spectrum antibiotics increases colonization with antibiotic resistant bacteria. Antibiotic therapy also induces perturbations of the non-resilient early life microbiota with potentially long lasting negative impact on the individual's own health. Currently there is no uniform consensus definition for neonatal sepsis. This leads to variations in management. Two factors may reduce the number of culture-negative sepsis cases. First, obtaining adequate blood cultures (0.5-1 mL) at symptom onset is mandatory. Unless there is a strong clinical or biochemical indication to prolong antibiotics physician need to trust the culture results and to stop antibiotics for suspected sepsis within 36-48 h. Secondly, an international robust and pragmatic neonatal sepsis definition is urgently needed. Neonatal sepsis is a dynamic condition. Rigorous evaluation of clinical symptoms ("organ dysfunction") over 36-48 h in combination with appropriately selected biomarkers ("dysregulated host response") may be used to support or refute a sepsis diagnosis.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.