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Few neonates empirically treated for early-onset sepsis are found to have an infection, leading to antibiotic overuse. Procalcitonin has been demonstrated to have a high negative-predictive value for serious bacterial infection in infants and children, but its role in the first few days after birth, when perinatal factors may complicate its interpretation, has not been demonstrated.
In a multicenter, multinational trial, researchers enrolled 1700 neonates classified as having low or medium risk for early-onset sepsis who had begun receiving antibiotics in the first 72 hours postpartum. They were randomized to management with use of multiple procalcitonin measurements or standard of care, which included laboratory evaluation (complete blood c…