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Antibiotic Therapy for the Prevention and Treatment of Neonatal Sepsis

Sarah A Coggins1, Karen M Puopolo1

  • 1Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, University of Pennsylvania, Philadelphia, PA, USA.

Clinics in Perinatology
|August 5, 2026
PubMed

Insights

Antibiotics are frequently used in neonatal intensive care units for infections like sepsis. This review covers neonatal antimicrobial pharmacology and drug data to guide treatment decisions for vulnerable infants.

Area of Science:

  • Neonatal pharmacology
  • Infectious disease in neonates
  • Antimicrobial stewardship

Background:

  • Antibiotics are widely used in neonatal intensive care units (NICUs) for preterm and term infants.
  • Infants may be exposed to antibiotics prenatally, at birth, or during NICU stays for suspected early- or late-onset sepsis.
  • Antibiotic selection is complex, requiring consideration of infection timing, microbiology, patient factors, and resistance patterns.

Purpose of the Study:

  • To summarize fundamental concepts of neonatal antimicrobial pharmacology.
  • To present available neonatal-specific pharmacokinetic/pharmacodynamic (PK/PD) data for common antibiotics.

Main Methods:

  • Review of existing literature on neonatal antibiotic use.
  • Compilation of PK/PD data for frequently prescribed antimicrobial agents in neonates.

Main Results:

  • Discussion of key principles governing antibiotic behavior in neonates.
  • Presentation of PK/PD profiles for commonly used antibiotics, highlighting differences from adult data.

Conclusions:

  • Optimizing antibiotic therapy in neonates requires understanding their unique pharmacology.
  • Neonatal-specific PK/PD data are crucial for effective and safe antimicrobial treatment, guiding appropriate dosing and selection.

Keywords:
AntibioticInfantInfectionNeonatePharmacology

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