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Many newborns are exposed to diagnostic or treatment procedures due to a suspicion of sepsis. Since non-specific signs of neonatal sepsis can quickly proceed to a life-threatening condition, it is essential to have a low threshold to diagnostic procedures and to provide antimicrobial therapy while waiting for the test results. After sepsis has been ruled out, antimicrobial therapy should be discontinued without delay. Good clinical practice includes avoiding unnecessarily broad-spectrum antibiotics. The future challenge is to develop a sensitive and specific marker for early detection of the disease and for avoiding unnecessary antibiotics, hospital care days and mother-infant separation.

At birth the immune system of a neonate is immature and viruses can cause severe infections. Since the signs and symptoms of postnatal viral diseases can be identical to those in bacterial infections, viral diseases are often treated with antibiotics. Any infant with signs of serious infections, in whom no bacteria are found, should be suspected for a viral infection. Prevention of transmission of viruses and cohorting of infected infants should be practiced in NICUs. Since postnatal viral infections can have a long-term impact on the health in a child, all effective preventive and curative interventions should be utilized.

With active research work, neonatology has developed into an increasingly evidence-based sector of medicine. Research evidence also supports the change towards a more patient-friendly and family-centered direction. The therapy aims to optimize protection of the brain, in order to thereby improve the developmental prognosis of premature infants. It is therefore important to provide for the developmental follow-up of premature infants. Regionalization of very premature deliveries into university hospitals will decrease mortality.