Infant inclusion criteria | Newborn infants born with gestational age 23–28 6/7 weeks |
Infants delivered at participating study sites | |
Infant exclusion criteria | Infants at low risk for early-onset-sepsis: infants born for maternal indications via caesarean section with rupture of membranes within 6 h of delivery, no attempts to induce labor, or no concern for maternal infection |
Infants at high risk for early-onset-sepsis: infants born to mothers with intrapartum fever >38 °C or infants with clinical diagnosis of chorioamnionitis (suspected or definite) | |
Infants with respiratory insufficiency requiring invasive mechanical ventilation and FiO2 > 0.40 or non-invasive ventilation (i.e., CPAP) with FiO2 > 0.60 at time of randomization | |
Infants with ongoing hemodynamic instability requiring vasopressors or more than one 10 ml/kg NS bolus at time of randomization | |
Clinician concern for sepsis due to physical exam findings (i.e., minimal responsiveness, poor tone) | |
Major congenital abnormalities (i.e., cardiac, pulmonary, gastrointestinal anomalies) | |
Infants not anticipated to survive beyond 72 h | |
Infants who have received antibiotics prior to randomization | |
Maternal exclusion criteria | Mothers that are <18 years old at time of consent |