Though the authors rightly excluded the extremely low birth weight (ELBW) neonates from the study, considering preterm (neonates >30 wk gestation) and term neonates together may put the former at disadvantage since the risk of escalating sepsis is higher in preterms [2]. The authors have not indicated, how many cases in short-course group were term newborns. Similarly, there are major differences in the etiology, spectrum and severity of early and late onset sepsis; therefore, it may not be logical to combine these two in one study group. Moreover, even in early-onset cases, babies whose mother received antibiotics during labor fare differently and decision to continue antibiotic therapy has to be individualized [3].

The need for limiting the duration of empirical antibiotic therapy in newborns with high suspicion of sepsis is a good idea to avoid emergence of antibiotic resistance and limit the duration of hospital stay and the costs involved. However, such a strategy, probably, is prudent in late-onset sepsis cases started on broad-spectrum and higher antibiotics (like meropenem, etc.) to treat culture-negative sepsis.

Finally, since we treat the disease and not the terminology of ‘probable sepsis’, one should keep in mind that, among early-onset cases, newborns with probable sepsis who recovered within 48 to 72 hours were probably not sepsis and needed no antibiotics at all.

1. Saini SS, Dutta S, Ray P, Narang A. Short course versus 7-Day course of intravenous antibiotics for probable neonatal septicemia: A pilot, open-label, randomized controlled trial. Indian Pediatr. 2011;48:19-24.

2. Stoll BJ. Infections of the neonatal Infant. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF eds. Nelson Textbook of Pediatrics.18th ed. Philadelphia: Elsevier Saunders; 2007. p.794-811.