{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:58:20Z","timestamp":1786125500244,"version":"build-2736575974"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Prolonged empirical antibiotic exposure in neonates is associated with adverse outcomes and antimicrobial resistance. Serial C-reactive protein (CRP) and procalcitonin (PCT) measurements may support earlier discontinuation, but neonatal protocols remain heterogeneous. To map evidence on CRP- and\/or PCT-guided antibiotic-duration strategies in neonatal sepsis and summarize their effects on antibiotic exposure and safety. Following Joanna Briggs Institute guidance and PRISMA-ScR, PubMed\/MEDLINE, Embase, Web of Science and the Cochrane Library were searched from inception to December 2023. Peer-reviewed English-language studies of neonates aged 0\u201328 days with suspected, probable or culture-proven early- or late-onset sepsis were included when serial CRP and\/or PCT formed part of an explicit antibiotic-stopping strategy. Two reviewers independently screened records and charted study characteristics, protocols and outcomes. Fifteen studies involving 4755 neonates were included: five randomized trials, six cohort studies, two prospective observational studies and two systematic reviews with meta-analyses. Seven studies evaluated CRP-guided discontinuation, six evaluated PCT-guided strategies and four used combined approaches. Biomarker-guided care reduced mean antibiotic duration from 7.3 to 4.5 days, a mean reduction of 2.8 days (38.6%). Reductions were directionally consistent and appeared greater in early-onset than late-onset sepsis. Thirteen studies reported treatment failure and 14 reported mortality; neither outcome showed an apparent increase with biomarker-guided discontinuation. Antimicrobial-resistance, ecological and cost outcomes were infrequently reported. CRP- and\/or PCT-guided stopping strategies may reduce antibiotic exposure in neonatal sepsis without an apparent increase in treatment failure or mortality. Standardized protocols and further implementation, cost-effectiveness and resistance-focused research are needed, particularly in resource-limited settings and extremely preterm infants.<\/jats:p>","DOI":"10.1093\/tropej\/fmag052","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T11:29:06Z","timestamp":1784633346000},"source":"Crossref","is-referenced-by-count":0,"title":["Biomarker-guided antibiotic duration strategies using C-reactive protein and\/or procalcitonin for neonatal sepsis: a scoping review"],"prefix":"10.1093","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7284-2915","authenticated-orcid":false,"given":"Aditya Hemendra","family":"Bhatt","sequence":"first","affiliation":[{"name":"Department of Neonatology, Pramukhswami Medical College, Bhaikaka University , Karamsad, Gujarat, 388325,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3527-1831","authenticated-orcid":false,"given":"Ankur","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Government Medical College , Surat, Gujarat, 395001,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praful","family":"Bhambharoliya","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Government Medical College , Surat, Gujarat, 395001,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirti","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Government Medical College , Surat, Gujarat, 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