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October 17, 1980

Antibiotics for Neonates

Author Affiliations

St Louis City Hospital

JAMA. 1980;244(16):1782-1783. doi:10.1001/jama.1980.03310160010005

To the Editor.—  The article on antibiotic usage by Naqvi et al (242:1981, 1979) contained what I consider to be serious flaws in the evaluation of appropriateness of the use of therapy with antibiotics in the neonatal population. Their conclusions that only 50% of antibiotics used was appropriate reflect a bias that is not consistent with generally accepted good neonatal practice. The two major categories cited were the following: (1) antibiotic therapy continued for too long a period and (2) indicated studies not done. For the first category two comments might be made. The authors themselves admit that in the too-long category, antibiotic therapy was often continued because of clinical improvement coincidental with the initiation of antibiotic therapy. The lack of 100% positive bacterial culture results in the neonatal population is well known. Indeed, in a recent study, Squire et al1 reported a series of neonatal sepsis in which