Objective: This study evaluates the time to blood culture positivity among neonates evaluated for sepsis to determine when antibiotics may be safely discontinued.
Study design: Retrospective review of clinically relevant blood culture time to positivity from infants in a neonatal intensive care unit. The primary endpoint was overall median time to blood culture positivity. Secondary endpoints compared time to positivity among gram-positive versus gram-negative organisms, early versus late onset sepsis, and a sub-analysis excluding contaminants.
Result: Among 151 cultures, the overall median time to positivity was 17 h (IQR 12-23). Most (47/48, 97.9%) gram-negative organisms resulted within 24 h and most (88/94, 93.6%) gram-positive by 36 h. All (13/13, 100%) early onset cultures resulted within 24 h and most (132/138, 95.7%) late onset by 36 h.
Conclusion: Antibiotics for neonatal sepsis evaluation may be safely discontinued in well-appearing infants without an identified infection source with negative cultures at 36 h.
© 2025. The Author(s), under exclusive licence to Springer Nature America, Inc.