Selective Antibiotics When Symptoms Develop Versus Universal Antibiotics for Preterm Neonates

Inclusion criteria: * Gestational age of 26 0/7 to 34 6/7 weeks * Chronological age 4 hours * Have any one or both of the following risk factors of EONS: * Prolonged rupture of membranes \>18 hours * Pre-labour rupture of membranes \[as all subjects will be preterm, this is effectively pPROM\] * Are either asymptomatic or have no signs attributable to sepsis at 4 hours. This will be defined as absence of the following clinical signs or need for interventions mentioned below: 1. Apnea (Standard definition) requiring intervention at any time until enrolment. 2. Need for a fluid bolus or inotropic support at any time until enrolment. 3. Seizures or seizure-like activity at any time until enrolment. 4. Upper GI bleed in the absence of a history of ante-partum hemorrhage at any time until enrolment. 5. Pus from any site at any time until enrolment. 6. Need for CPAP \>6 cms of water with FiO2 \>35% at 4 hours OR need for CPAP less than or equal to 6 cms and FiO2 less than or equal to 35% but with increasing requirement of support 7. Chest Xray (if performed) with radiological features of pneumonia. 8. Need for intubation and mechanical ventilation. 9. Temperature \>37.5°C or \<36°C, unexplained by environmental causes 10. Feed intolerance \[bilious or bloodstained vomiting (or gastric residuals) or visibly distended abdomen or \>50% of the previous feed volume as gastric residuals\] 11. Lethargy or unarousability 12. Sclerema Exclusion Criteria: Subjects will be excluded if they have any 1 of the following: <!-- --> 1. Life-threatening congenital malformation 2. Severe perinatal asphyxia (Apgar score \<5 at 10 minutes or cord pH \<7.0) 3. Clinical chorioamnionitis# \[see definition below\] 4. Foul-smelling liquor 5. Multiple gestation 6. Received a dose of antibiotics 7. Positive amniotic fluid culture (if performed and available prior to randomization) 8. Treating neonatologist unwilling to enroll the patient in the trial on the grounds that the patient needs antibiotics. \-