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October 17, 1980

Antibiotics for Neonates-Reply

Author Affiliations

Cardinal Glennon Memorial Hospital for Children St Louis

JAMA. 1980;244(16):1783. doi:10.1001/jama.1980.03310160010006

In Reply.—  We appreciate Dr Walentik's careful assessment of our article and the opportunity to elaborate on our criteria for use of antibiotics in the nursery.The use of 72 hours as a limit for antibiotic administration in blood culture-negative infants is supported by the additional fact that surface cultures, particularly of the nasopharynx, were considered reliable as well. That is, group B Streptococcus or other recognized pathogens found in the nasopharynx or a number of other areas were considered adequate documentation for continued antibiotic therapy. Furthermore, there is no evidence, regardless of common practice, that five days is required to allow bacterial culture yields to show a diagnosis. To the contrary, the dense bacteremia generally present in infected neonates allows a more rapid bacteriologic diagnosis.1 We believe that if bacterial infection is suspected strongly on clinical grounds alone, therapy must be continued for the standard ten to 14