To be certain about using or not using antibiotic therapy for a neonate is often problematic as signs and symptoms of sepsis are non-specific but at the same time both mortality and morbidity from sepsis in the neonatal period is substantial. This uncertainty has led many newborns to be prescribed antibiotics when they do not have infection, increasing not only bacterial resistance to antibiotics but also long term morbidity like asthma and obesity amongst neonates who receive antibiotics for longer than five days in the neonatal period. In this review we have attempted to provide an evidence based rationale for prescribing antibiotics for neonatal sepsis and suggest a practice guidelines that is not only relevant to Pakistan but also to many other resource limited countries
