A Wrinkle in Time to Antibiotics in Sepsis: When Should ONE Hour Be the Goal?

Abstract

universal treatment of all patients to avoidance of treatment; such polarization is both biologically implausible and clinically hazardous. It is now incumbent on neonatologists to study patients who have clear evidence of PDA-attributable hemodynamic instability, evaluate the physiologic impact of definitive methods to modulate the PDA shunt with absolute resolution of any hemodynamic disturbance, and finally characterize the downstream effects of shunt elimination on relevant shortterm morbidities and their long-term ramifications. Until these conditions are met, we run the risk of repeating past mistakes and positively contributing to clinical uncertainty, evangelical opinion, and extremes of therapeutic practices. n