Neonatal Early-Onset Sepsis: Epidemiology, Microbiology, and Controversies in Practice

Early-onset sepsis (EOS) remains a substantial contributor to neonatal morbidity and mortality. Continued epidemiologic surveillance of incidence, risk factors, and microbiology is paramount to developing new prevention strategies and optimizing antibiotic administration. Understanding the risks and benefits of maternal antibiotic exposure and neonatal risk assessment can inform clinical management. Maternal vaccination during pregnancy is a promising avenue for EOS prevention, particularly against group B Streptococcus. When EOS is suspected, ampicillin and gentamicin are the appropriate routine empiric regimen in most cases. Finally, a deeper understanding of the existing disparities in EOS can shed light on how to provide more equitable care.