[Current orientation of antibiotic treatment in neonatal bacterial infection].

The bacterial infection are responsive of severe sepsis and localizations in neonates, with a high mortality. The right choice of the first antibiotics is essential, and they must be well-fitted, early and bactericidal. The antibiotics of choice in the mother-linked infections are directed towards streptococcus group B and E. coli. Ampicillin must be replaced by a third generation cephalosporin because E. coli are resistant in more than 50% of cases. In tropical areas the first neonatal infections may be also the fact of multiresistant hospital acquired bacteria, which are transmitted during delivery by lack of hygiene. As in the nosocomial infections the causative pathogens are resistant Enterobacteriaceae, Pseudomonas and Staphylococcus. In all cases the neonatologist must use cephalosporin 3rd generation associated to aminoglycoside. The biological background and the cost of those antibiotics must be reevaluated in the high risk-areas (delivery rooms, nurseries, pediatrics departments).