Transforming therapies for neonatal sepsis: Insights into the drug delivery via nanosomes and extracellular vesicles.

Neonatal sepsis is an acute disease caused by distinct pathogens in the blood of neonates who are under 28 days old. It affects 1-5 neonates per 1000 live births worldwide. This review article discusses the pathophysiology and prevalence of the causative microorganisms, along with their Gram characteristics, clinical manifestations, commonly used antibiotics, and associated side effects. It also covers current diagnostic approaches and treatment strategies, such as empirical antibiotic therapy and immunomodulatory interventions. Furthermore, the manuscript elaborates on the potential role of nanocarrier-based drug delivery systems in treating the disease. Ampicillin and gentamicin are commonly used as first-line antibiotic treatments. Several other antibiotics have also been listed as part of proposed empirical therapies for this disease. In addition, immunomodulatory therapy may aid in supporting immune system development, potentially offering a better option for neonates depending on their health conditions. Moreover, studies have demonstrated that biological nanosomes and extracellular vesicles serve as effective drug delivery systems, employing both active and passive loading techniques. These nanodrug delivery systems offer high encapsulation efficiency, enhanced stability, and improved bioavailability, while demonstrating low cytotoxicity upon delivery into the host. Therefore, we have incorporated the concept of enhancing treatment efficacy through the use of nanosomes and extracellular vesicles in our manuscript. In conclusion, further research on nanocarrier-based delivery systems is essential for effective delivery of antimicrobial agents targeting intracellular multidrug-resistant pathogens responsible for neonatal sepsis.