We appreciate the comments made by Dr Del Vecchio. We intended our article1 to generate productive debate on this important and common clinical issue. The epidemiology of invasive bacterial infections in children aged 60 days or younger is changing,2- 4 and we must carefully consider existing recommendations for antibiotic treatment to make sure that the recommendations continue to afford optimal coverage of these infections. We stand by our conclusion that certain medical centers may wish to change their initial empiric antibiotic therapy to a third-generation cephalosporin with or without gentamicin for certain febrile infants aged 60 days or younger evaluated as outpatients. Nonetheless, Del Vecchio's letter raises important issues, and we wish to respond to his concerns sequentially.
Berger Sadow K, Téach SJ. Choice of Antibiotics in Febrile Neonates. Arch Pediatr Adolesc Med. 2000;154(2):205-206. doi: