title: Rational development of guidelines for management of neonatal sepsis in developing countries.
abstract: OBJECTIVE
  This review discusses the rational development of guidelines for the management of neonatal sepsis in developing countries.
  
  
  RESULTS
  Diagnosis of neonatal sepsis with high specificity remains challenging in developing countries. Aetiology data, particularly from rural, community-based studies, are very limited, but molecular tests to improve diagnostics are being tested in a community-based study in South Asia. Antibiotic susceptibility data are limited, but suggest reducing susceptibility to first-and second-line antibiotics in both hospital and community-acquired neonatal sepsis. Results of clinical trials in South Asia and sub-Saharan Africa assessing feasibility of simplified antibiotic regimens are awaited.
  
  
  CONCLUSIONS
  Effective management of neonatal sepsis in developing countries is essential to reduce neonatal mortality and morbidity. Simplified antibiotic regimens are currently being examined in clinical trials, but reduced antimicrobial susceptibility threatens current empiric treatment strategies. Improved clinical and microbiological surveillance is essential, to inform current practice, treatment guidelines, and monitor implementation of policy changes.
authors.affiliation: aDepartment of Infectious Diseases Informatics, UCL Institute for Health Informatics, Farr Institute, University College London bImperial NHS Trust, London, UK cKEMRI/Wellcome Trust Research Programme, Kilifi, Kenya dThe Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, UK.
authors.forename: Anna C
authors.initials: AC
authors.lastname: Seale
authors.forename: Christina W
authors.initials: CW
authors.lastname: Obiero
authors.forename: James A
authors.initials: JA
authors.lastname: Berkley
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017714:Community-Acquired Infections / Q000188:drug therapy; D003906:Developing Countries / Q000706:statistics & numerical data; D005240:Feasibility Studies; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D017410:Practice Guidelines as Topic; D018571:Sentinel Surveillance; D018805:Sepsis / Q000188:drug therapy* / Q000401:mortality; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents