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Procalcitonin (PCT) is used for sepsis risk-stratification in well-appearing febrile infants and has been shown to be useful for antibiotic stewardship in early-onset neonatal sepsis. However, its role in late-onset neonatal sepsis (occurring after 3 days of life) is less certain.
To address this gap, investigators randomized 504 newborns with suspected or proven late-onset sepsis across 33 French hospitals to receive either PCT-guided care or usual care. In the intervention group, antibiotic discontinuation was recommended when PCT levels declined to ≤0.5 μg/l. Eligible newborns were ≥4 days old and required >48 hours of antibiotics; those with septic shock, meningitis, or other infections requiring prolonged antibiotic therapy were …