Čes-slov Pediat 2026, 81(4):185-189 | DOI: 10.55095/CSPediatrie2026/034

Choosing Wisely: Antibiotics in neonates and the duration of their administration

Tomáš Matějek, Veronika Pokorná

Dětská klinika, Lékařská fakulta, Univerzita Karlova v Hradci Králové a Fakultní nemocnice Hradec Králové

The European Academy of Paediatrics Choosing Wisely recommendations focus on rational antibiotic use in neonates, aiming to reduce overuse and shorten treatment duration. This article critically analyses the evidence supporting two key principles: avoiding antibiotic therapy in asymptomatic term and late preterm neonates without clinical signs of sepsis, and discontinuing empiric antibiotics withi

n 36-48 hours in the presence of a negative blood culture and favourable clinical course. Limitations of current diagnostic approaches, including blood culture interpretation, and factors influencing clinical decision-making are discussed. Practical aspects of implementation are also addressed, including communication strategies and organisational barriers. Current evidence supports the safety and

rationale of these recommendations in routine neonatal practice.

Keywords: neonate, early-onset sepsis, antibiotic therapy, treatment duration, blood culture, antibiotic stewardship, Choosing Wisely

Accepted: June 2, 2026; Published: June 1, 2026  Show citation