ReviewNature communications2023
Less is more: Antibiotics at the beginning of life.
Review in Nature communications, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 69 papers, 3 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
69 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Pediatric stewardship in Italy: a necessity, not an option - a National Multi-Society Expert Consensus on Antimicrobial and Diagnostic Stewardship (SIP, SITIP, SIMRI, SIAIP, SIMEUP, SIPPS, SICUPP, SIMIT, SIMPE, SIPINF, SIT, SIAATIP, SARNEPI, AIEOP, SIM, SITI, SIF, SIFACT, SITA, SIN).Italian journal of pediatrics · 2025Pooled it
- 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
- Management of neonates at risk of early onset sepsis: a probability-based approach and recent literature appraisal : Update of the Swiss national guideline of the Swiss Society of Neonatology and the Pediatric Infectious Disease Group Switzerland.European journal of pediatrics · 2024Guideline
- Sepsis and Antibiotics in Extremely Preterm Infants: Early Empirical Treatment Was Common, While Late-Onset Sepsis Accounted for Most Cases and Antibiotic Use.Acta paediatrica (Oslo, Norway : 1992) · 2026Article
- Promotion of long-term health in early life.Proceedings of the National Academy of Sciences of the United States of America · 2026Article
- International Variations in the Use of Antimicrobials and Management of Sepsis: A Survey of 382 Neonatal Units in 12 Countries.Neonatology · 2026Article
- Plasticity of the infant immune system during the perinatal period.Nature reviews. Immunology · 2026Review
- Patterns of Antibiotic Dispensing Among New Zealand Children: A Linkage Study.Pharmacoepidemiology and drug safety · 2026Article
- Antibiotic exposure in culture-negative preterm infants: a 10-year single-centre study.Pediatric research · 2026Article
- Supplementation with long-chain polyunsaturated fatty acids to extremely preterm infants associates with development of the intestinal microbiota.Pediatric research · 2026Article
- Diagnostic challenges and Gram-negative pathogen dominance in early- and late-onset neonatal infection in Manila, Philippines.Nature communications · 2026Article
- Antibiotic overuse in children with viral infections: lessons from the SARS-CoV-2 pandemic.BMJ paediatrics open · 2026Article
- Impact of implementing a clinical decision rule on the use of empirical antibiotics and invasive procedures.BMJ paediatrics open · 2026Article
- Revisiting time to blood culture positivity: can we decrease antibiotic exposure in the NICU?Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Blood cultures to define neonatal early-onset sepsis: why not enough for clinical care?Pediatric research · 2026Article
- Real-world use of Serial Clinical Observation in culture-proven early-onset sepsis: timing of recognition, treatment and retrospective comparison with the Neonatal Sepsis Calculator.European journal of pediatrics · 2026Observational
- Restricting C-Reactive Protein Use in Early-Onset Neonatal Sepsis Reduces Unnecessary Antibiotic Exposure.Antibiotics (Basel, Switzerland) · 2026Article
- Acquired Immunodeficiency in Newborn Following Intrauterine Exposure to Thiopurines for Treatment of Inflammatory Bowel Disease.ACG case reports journal · 2026Article
- Variations in antibiotic use in late preterm and term newborns from 2012 to 2020: a nationwide population-based observational study.Archives of disease in childhood. Fetal and neonatal edition · 2026Observational
- Neonatal leucocyte cell population data: reference intervals and relevance for detecting sepsis and necrotizing enterocolitis.Pediatric research · 2026Article
9 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
25 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Antibiotic exposure at the beginning of life can lead to increased antimicrobial resistance and perturbations of the developing microbiome. Early-life microbiome disruption increases the risks of developing chronic diseases later in life. Fear of missing evolving neonatal sepsis is the key driver for antibiotic overtreatment early in life. Bias (a systemic deviation towards overtreatment) and noise (a random scatter) affect the decision-making process. In this perspective, we advocate for a factual approach quantifying the burden of treatment in relation to the burden of disease balancing antimicrobial stewardship and effective sepsis management.
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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.