# The Angel in the Marble: Antibiotic Duration in the Neonatal Intensive Care Unit

## TL;DR

This paper reviews how long antibiotics should be given to infants in the NICU and suggests ways to safely shorten treatment durations.

## Contribution

The paper proposes a goal-based approach to determine optimal antibiotic duration in neonatal care.

## Key findings

- Current evidence on antibiotic treatment duration for neonates is limited and inconsistent.
- Shorter treatment durations could be investigated safely with a structured clinical approach.
- More research is needed in specific clinical scenarios to guide antibiotic stewardship.

## Abstract

Antimicrobial stewardship in the neonatal intensive care unit is a critically important tool to optimize clinical outcomes. The ideal duration of antimicrobial treatment is a key area that contains many knowledge gaps. This narrative review has three aims. One, to highlight the existing evidence for empiric and definitive antibiotic treatment durations for infants; two, to focus on clinical situations where further studies are needed; and three, to propose a rational, goal-based approach to clinical studies that provide for infant safety as shorter treatment durations are investigated.