some clinicians use diagnostic tests
with a high negative predictive accuracy
as reassurance that infection is not
present (allowing them to withhold
antimicrobial agents). The decision of
whether to treat a high-risk infant
depends on the risk factors present,
the frequency of observations, and
gestational age. The threshold for
initiating antimicrobial treatment generally
decreases with increasing numbers
of risk factors for infection and
greater degrees of prematurity. Suggested
algorithms for management of
healthy-appearing, high-risk infants are
shown in Figs 1, 2, and 3. Screening
blood cultures have not been shown to
be of value