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In infants who require empiric therapy for early-onset sepsis, ampicillin and an aminoglycoside with dosing based on recent pharmacokinetic studies represents the most appropriate first-line agents; third-generation cephalosporins should be reserved for patients with a high likelihood of Gram-negative meningitis. An antistaphylococcal penicillin and gentamicin should be utilized for suspected late-onset sepsis. Vancomycin and other broad-spectrum agents are reserved for patients with a history of resistant organisms. Antibiotic duration should be guided by understanding the clinical indications and obtaining the necessary cultures appropriately (i.e., adequate volume blood cultures). In the absence of a positive culture, antibiotic duration should often be limited. Individual institutions should leverage a multidisciplinary, interprofessional team to identify opportunities for antimicrobial stewardship. A collaborative, transparent system is required to change unit culture and generate a sustained impact on antibiotic utilization with optimal patient outcomes.<\/jats:p>","DOI":"10.1891\/0730-0832.37.2.116","type":"journal-article","created":{"date-parts":[[2018,4,4]],"date-time":"2018-04-04T00:32:11Z","timestamp":1522801931000},"page":"116-123","source":"Crossref","is-referenced-by-count":16,"title":["Antimicrobial Stewardship in Neonates: Challenges and Opportunities"],"prefix":"10.1891","volume":"37","author":[{"given":"Christopher","family":"McPherson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caren","family":"Liviskie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandy","family":"Zeller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miranda P.","family":"Nelson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason G.","family":"Newland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"793","published-online":{"date-parts":[[2018,1,1]]},"reference":[{"key":"2019091815554784000_37.2.116.1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-2217"},{"key":"2019091815554784000_37.2.116.2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.110.2.285"},{"key":"2019091815554784000_37.2.116.3","doi-asserted-by":"publisher","DOI":"10.1097\/01.inf.0000131633.74921.90"},{"key":"2019091815554784000_37.2.116.4","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2012.167"},{"key":"2019091815554784000_37.2.116.5","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1333412"},{"key":"2019091815554784000_37.2.116.6","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1361933"},{"key":"2019091815554784000_37.2.116.7","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-3409"},{"issue":"3","key":"2019091815554784000_37.2.116.8","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1097\/INF.0000000000000542","article-title":"Prospective surveillance of antibiotic use in the neonatal intensive care unit: results from the SCOUT study","volume":"34","year":"2015","journal-title":"Pediatr Infect Dis J"},{"key":"2019091815554784000_37.2.116.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2014.01.010"},{"key":"2019091815554784000_37.2.116.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2010.06.004"},{"key":"2019091815554784000_37.2.116.11","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-3423"},{"key":"2019091815554784000_37.2.116.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2011.05.033"},{"key":"2019091815554784000_37.2.116.13","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.jpeds.2016.11.002","article-title":"Antibiotic exposure and risk for death or bronchopulmonary dysplasia in very low birth weight infants","volume":"181","year":"2017","journal-title":"J Pediatr"},{"key":"2019091815554784000_37.2.116.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2011.02.035"},{"key":"2019091815554784000_37.2.116.15","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-2092"},{"key":"2019091815554784000_37.2.116.16","doi-asserted-by":"crossref","unstructured":"Benitz WE , Gould JB , Druzin ML. 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