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World J Clin Pediatr. Sep 9, 2026; 15(3): 120971
Published online Sep 9, 2026. doi: 10.5409/wjcp.120971
Published online Sep 9, 2026. doi: 10.5409/wjcp.120971
Antibiotic stewardship in the context of management of early onset neonatal sepsis-an evolving paradigm shift
Amit Kandhari, Megha Jagga, Sujoy Banerjee, Neonatal Medicine, Singleton Hospital, Swansea SA2 8QA, United Kingdom
Co-first authors: Amit Kandhari and Megha Jagga.
Author contributions: Jagga M, Kandhari A, and Banerjee S contributed to the conception and design of this mini review; Jagga M and Kandhari A performed the initial literature search prepared the initial draft of the manuscript, qualified as the co-first authors of the paper; screening of relevant articles was undertaken collaboratively by all three authors; Banerjee S critically revised and refined the manuscript; and all authors reviewed and approved the final version of the manuscript.
AI contribution statement: The scientific content of this manuscript, including literature review, research methods, evidence interpretation, critical analysis, and conclusion, was independently written, reviewed and approved by the author. Only Microsoft Copilot and Grammarly, etc. - these types of artificial intelligence tools - were used for grammar correction, sentence reorganization, readability improvement and editing and proofreading. No part of the manuscript was completely generated by artificial intelligence, and all content has been extensively verified and revised by the authors. Artificial intelligence tools were not used for research design, literature selection, data analysis or result interpretation. The manuscript does not contain any images generated by artificial intelligence. The author is fully responsible for the accuracy, completeness and originality of this work.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Sujoy Banerjee, Professor, Neonatal Medicine, Singleton Hospital, Sketty Lane, Swansea SA2 8QA, United Kingdom. sujoybanerjee@doctors.org.uk
Received: March 12, 2026
Revised: April 28, 2026
Accepted: May 21, 2026
Published online: September 9, 2026
Processing time: 143 Days and 2.7 Hours
Revised: April 28, 2026
Accepted: May 21, 2026
Published online: September 9, 2026
Processing time: 143 Days and 2.7 Hours
Core Tip
Core Tip: Early-onset neonatal sepsis is rare yet fear of missed serious infection continues to drive widespread empirical antibiotic use, exposing large numbers of well newborns to avoidable harm. This review synthesises contemporary evidence underpinning the paradigm shift in neonatal antibiotic stewardship, critically comparing traditional categorical guidelines with multivariate risk prediction tools and serial physical examination strategies. By integrating epidemiology, emerging United Kingdom and international data, and evolving clinical practice, it provides practical insights into how antibiotic exposure can be safely reduced without compromising outcomes, supporting more precise, family-centred, and evidence-based care.