What do systematic reviews say?

Antibiotics vs no antibiotics

Antibiotics showed no clear difference in mortality (before discharge) compared with control (no antibiotics) (low certainty).

• Antibiotics for neonates born through meconium‐stained amniotic fluid 2017 · Cochrane Headline outcomes only
  RR 1.69 [0.23, 12.53]
  3 studies · 445 participants
  Low

Antibiotics vs no antibiotics

Antibiotics showed no clear difference in mortality (before discharge) compared with control (no antibiotics) (low certainty).

• Antibiotics for neonates born through meconium‐stained amniotic fluid 2017 · Cochrane Headline outcomes only
  RR 1.07 [0.22, 5.18]
  1 study · 250 participants
  Low

Antibiotics on removal of central venous catheter vs no antibiotics

• Antibiotics at the time of removal of central venous catheter to reduce morbidity and mortality in newborn infants 2018 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 88 participants
  Low

Antibiotics on removal of central venous catheter vs no antibiotics

• Antibiotics at the time of removal of central venous catheter to reduce morbidity and mortality in newborn infants 2018 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 88 participants
  Low

Antibiotics on removal of central venous catheter vs no antibiotics

• Antibiotics at the time of removal of central venous catheter to reduce morbidity and mortality in newborn infants 2018 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 88 participants
  Low

Pentoxifylline with antibiotics (any dose or duration) vs immunoglobulin M‐enriched intravenous immunoglobulin with antibiotics

It is very uncertain whether pentoxifylline with antibiotics (any dose or duration) changes all‐cause mortality during hospital stay compared with immunoglobulin M‐enriched intravenous immunoglobulin with antibiotics (very low certainty).

• Pentoxifylline for treatment of sepsis and necrotising enterocolitis in neonates 2023 · Cochrane Headline outcomes only
  RR 1.25 [0.36, 4.39]
  1 study · 102 participants
  Very low

Pentoxifylline with antibiotics (any dose or duration) vs pentoxifylline with antibiotics and immunoglobulin M‐enriched intravenous immunoglobulin

It is very uncertain whether pentoxifylline with antibiotics (any dose or duration) changes all‐cause mortality during hospital stay compared with pentoxifylline with antibiotics and immunoglobulin M‐enriched… (very low certainty).

• Pentoxifylline for treatment of sepsis and necrotising enterocolitis in neonates 2023 · Cochrane Headline outcomes only
  RR 0.71 [0.24, 2.1]
  1 study · 102 participants
  Very low

Comparison 1: referral or full course of antibiotics vs usual care

It is very uncertain whether comparison 1: referral or full course of antibiotics changes neonatal mortality ‐ full course compared with standard care (very low certainty).

• Community‐based antibiotic delivery for possible serious bacterial infections in neonates in low‐ and middle‐income… 2019 · Cochrane Headline outcomes only
  RR 0.87 [0.72, 1.04]
  4 studies · 121779 participants
  Very low

Pentoxifylline with antibiotics (any dose or duration) vs placebo or no intervention

Pentoxifylline with antibiotics (any dose or duration) may leads to lower all‐cause mortality during hospital stay compared with placebo or no intervention (low certainty).

• Pentoxifylline for treatment of sepsis and necrotising enterocolitis in neonates 2023 · Cochrane Headline outcomes only
  RR 0.57 [0.35, 0.93]
  6 studies · 416 participants
  Low

Comparison 1: referral or full course of antibiotics vs usual care

Comparison 1: referral or full course of antibiotics may leads to lower neonatal mortality ‐ first dose and referral compared with standard care (low certainty).

• Community‐based antibiotic delivery for possible serious bacterial infections in neonates in low‐ and middle‐income… 2019 · Cochrane Headline outcomes only
  RR 0.57 [0.38, 0.83]
  1 study · 3355 participants
  Low

Comparison 1: antibiotic alone or antibiotic with other newborn care interventions vs usual care

Comparison 1: antibiotic alone or antibiotic with other newborn care… showed no clear difference in neonatal mortality ‐ antibiotics alone compared with standard care (moderate certainty).

• Community‐based antibiotic delivery for possible serious bacterial infections in neonates in low‐ and middle‐income… 2019 · Cochrane Headline outcomes only
  RR 1.07 [0.89, 1.29]
  1 study · 18747 participants
  Moderate
• Community‐based antibiotic delivery for possible serious bacterial infections in neonates in low‐ and middle‐income… 2019 · Cochrane Headline outcomes only
  RR 0.76 [0.62, 0.94]
  4 studies · 106387 participants
  Moderate

Comparison 1: route of antibiotic vs usual care

Comparison 1: route of antibiotic showed no clear difference in neonatal mortality ‐ oral + injectable antibiotics compared with standard care (moderate certainty).

• Community‐based antibiotic delivery for possible serious bacterial infections in neonates in low‐ and middle‐income… 2019 · Cochrane Headline outcomes only
  RR 0.99 [0.92, 1.06]
  2 studies · 79227 participants
  Moderate