Choosing Wisely: Antibiotics in neonates and the duration of their administration. A professional series of Czech and Slovak paediatrics based on the recommendations of the European Academy of Paediatrics

Czech version

Authors: Tomáš Matějek; Veronika Pokorná
Authors‘ workplace: Dětská klinika, Lékařská fakulta, Univerzita Karlova v Hradci Králové a Fakultní nemocnice Hradec Králové
Published in: Čes-slov Pediat 2026; 81 (4): 185-189.
Category: Choosing Wisely
doi: https://doi.org/10.55095/CSPediatrie2026/034

Overview

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 within 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 – antibiotic therapy – blood culture – Choosing wisely – antibiotic stewardship – early-onset sepsis – treatment duration

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