Neonatal sepsis is a clinical syndrome consisting of nonspecific symptoms and signs of infection, accompanied by a bacteraemia in the
first 28 days of life. The risk of neonatal sepsis and death increases with decreasing birth weight and gestational age. South African data
have reported the overall incidence of neonatal sepsis to be 8.5 - 10%, with late-onset sepsis accounting for most of these infections. The
diagnosis of neonatal sepsis is not always straightforward, and the initiation and continuation of antimicrobials in these situations relies on
good clinical judgment. The need for empirical antimicrobials is driven by the existence of risk factors for early-onset sepsis and clinical
symptoms and signs of late-onset sepsis. Antimicrobial stewardship programmes should be in place to guide clinicians to either stop,
change, or continue antimicrobials. Institution-specific knowledge of the most common pathogens and the antimicrobial susceptibility
pattern is important to prevent the emergence of further antimicrobial resistance.