Bloodstream infections (BSI) from coagulase-negative-staphylococci (CoNS) are among the most frequent healthcare-related infections. Their treatment involves the use of vancomycin, a molecule whose optimal pharmacokinetic/pharmacodynamic (PK/PD) target for efficacy and safety is an area-under-curve/minimum inhibitory concentration (AUC/MIC) ratio ≥ 400 with AUC < 600. BSIs from CoNS in pediatric and neonatal intensive care unit that occurred at the Gaslini Institute over five years were evaluated to investigate the efficacy of vancomycin therapy in terms of achieving the desired PK/PD target and determining whether any variables interfere with the achievement of this target. AUC/MIC ≥ 400 with AUC < 600 at 48 and 72 h after therapy initiation was achieved in only 21% of the neonatal population and 25% of the pediatric population. In the pediatric population, an inverse correlation emerged between estimated glomerular filtration rate (eGFR) and achieved AUC levels. Median eGFR at 72 h was significantly higher (expression of hyperfiltration) in events with AUC < 400, compared with those with AUC ≥ 400 (p < 0.001). A cut-off value of eGFR in the first 72 h has been identified (145 mL/min/1.73 m²), beyond which it is extremely unlikely to achieve an AUC ≥ 400, and therefore a higher dose or a different antibiotic should be chosen.

Background: Although home births provide personal and intimate experiences, they pose potential risks that may be better managed in hospital settings. The safety of home birth remains highly debated, with no consensus on its safety or potential adverse events, and its adoption varies widely across the world. In Italy, the Italian Society of Neonatology opposed this practice, resulting in one of the lowest home birth rates in Europe (approximately 0.1% of total births). This study evaluated the impact of planned home births on neonatal health, with a focus on severe complications requiring intervention in the pediatric emergency department (PED). Methods: Cases were collected from patients admitted to IRCCS Istituto Giannina Gaslini Children’s Hospital between January 2022 and December 2024. The analysis focused on neonates born at home, who required emergency care for life-threatening conditions. Results: We identified five cases, with an incidence of approximately 0.65 per 10,000 PED visits and a complication rate of 15–30% for all planned home births. Factors contributing to unfavorable outcomes include lack of advanced medical equipment, timely diagnostics, and comprehensive postpartum screening. Thus, while proponents argue that home births can provide a more comfortable and personalized experience, concerns about safety and associated risks persist. Conclusions: This study aims to highlight the necessity of adopting hospital-level neonatal care protocols for home births, particularly during the critical first 48 h of life, to mitigate risks and ensure optimal neonatal outcomes.