Evidence-based treatment of neonatal septicaemia

Sepsis is a major cause of newborn death world wide but the burden is heaviest in the developing parts of the world where the incidence of newborn sepsis is highest. Newborn sepsis is managed with a wide range of antibiotics in different parts of the world depending on the spectrum of bacterial aetiologies. Although, there are standard guidelines for the treatment of neonatal sepsis in most parts of the developed world, the situation is a lot different in most parts of the developing world. In the latter, differences exist in the pattern of risk factors for newborn sepsis, pattern of organisms as well as resistance pattern of these organisms. However, key issues in the management of newborn sepsis include selection of the most appropriate subjects for antibiotic therapy, choice of drugs to use, best regimen of drug treatment in terms of number of drugs and route of administration of drugs as well as the effectiveness of adjuvant therapies apart from antibiotics. These issues must be resolved in terms of the best proven efficiency. Clinicians and researchers need to know if certain traditional methods of treating newborn sepsis are really supported by the available scientific evidences gathered from many parts of the world. These form the focus of this review article which attempts to highlight the key areas in the management of neonatal septicaemia against the background of the peculiarities in the third world. The accompanying local challenges are also discussed. Key words: Antibiotics, newborn, sepsis