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Neonatal sepsis is an important cause of morbidity and mortality. Treatment choices are complicated by alterations in drug pharmacokinetics and pharmacodynamics in neonates, and a relative lack of data in this patient group relative to that in older children or adults. Prompt initiation of empirical antibacterial therapy is warranted, with modification based on blood culture results. Antifungals may also be useful, and prophylactic strategies are under investigation.