Screening for early-onset neonatal sepsis on the Kaiser Permanente sepsis risk calculator could reduce neonatal antibiotic usage by two-thirds
Screening for early-onset neonatal sepsis on the Kaiser Permanente sepsis risk calculator could reduce neonatal antibiotic usage by two-thirds
Importance: effective screening strategies for early-onset neonatal sepsis (EONS) have the potential to reduce high volume parenteral antibiotics (PAb) usage in neonates.
Objective: to compare management decisions for EONS, between CG149 National Institute for Health and Care Excellence (NICE) guidelines and those projected through the virtual application of the Kaiser Permanente sepsis risk calculator (SRC) in a level 2 neonatal unit at a district general hospital (DGH).
Methods: hospital records were reviewed for maternal and neonatal risk factors for EONS, neonatal clinical examination findings, and microbial culture results for all neonates born at ≥34 weeks' gestation between February and July 2019, who were (1) managed according to CG149-NICE guidelines or (2) received PAb within 72 h following birth at a DGH in Winchester, UK. SRC projections were obtained using its virtual risk estimator.
Results: sixty infants received PAb within the first 72 h of birth during the study period. Of these, 19 (31.7%) met SRC criteria for antibiotics; 20 (33.3%) met the criteria for enhanced observations and none had culture-proven sepsis. Based on SRC projections, neonates with '≥1 NICE clinical indicator and ≥1 risk factor' were most likely to have a sepsis risk score (SRS) >3. Birth below 37 weeks' gestation (risk ratio [RR] = 2.31, 95% confidence interval [CI]: 1.02-5.22) and prolonged rupture of membranes (RR = 3.14, 95% CI: 1.16-8.48) increased the risk of an SRS >3.
Interpretation: screening for EONS on the SRC could potentially reduce PAb usage by 68% in term and near-term neonates in level 2 neonatal units.
171-178
Fernandes, Michelle
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Winckworth, Lucinda
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Lee, Lyrille
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Akram, Madiha
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Struthers, Simon
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24 August 2022
Fernandes, Michelle
16d62e60-ae8e-455f-88d3-88e778253b4a
Winckworth, Lucinda
df3b0509-7a33-4498-932f-deb3267cfffd
Lee, Lyrille
9d3cdf90-eff9-4073-abbe-daebd5796249
Akram, Madiha
8da8ed95-8368-4652-b7e2-abc8bb78dfa1
Struthers, Simon
b47afcb3-74f4-4f9b-8a19-78ac9768bfa7
Fernandes, Michelle, Winckworth, Lucinda, Lee, Lyrille, Akram, Madiha and Struthers, Simon
(2022)
Screening for early-onset neonatal sepsis on the Kaiser Permanente sepsis risk calculator could reduce neonatal antibiotic usage by two-thirds.
Pediatric investigation, 6 (3), .
(doi:10.1002/ped4.12344).
Abstract
Importance: effective screening strategies for early-onset neonatal sepsis (EONS) have the potential to reduce high volume parenteral antibiotics (PAb) usage in neonates.
Objective: to compare management decisions for EONS, between CG149 National Institute for Health and Care Excellence (NICE) guidelines and those projected through the virtual application of the Kaiser Permanente sepsis risk calculator (SRC) in a level 2 neonatal unit at a district general hospital (DGH).
Methods: hospital records were reviewed for maternal and neonatal risk factors for EONS, neonatal clinical examination findings, and microbial culture results for all neonates born at ≥34 weeks' gestation between February and July 2019, who were (1) managed according to CG149-NICE guidelines or (2) received PAb within 72 h following birth at a DGH in Winchester, UK. SRC projections were obtained using its virtual risk estimator.
Results: sixty infants received PAb within the first 72 h of birth during the study period. Of these, 19 (31.7%) met SRC criteria for antibiotics; 20 (33.3%) met the criteria for enhanced observations and none had culture-proven sepsis. Based on SRC projections, neonates with '≥1 NICE clinical indicator and ≥1 risk factor' were most likely to have a sepsis risk score (SRS) >3. Birth below 37 weeks' gestation (risk ratio [RR] = 2.31, 95% confidence interval [CI]: 1.02-5.22) and prolonged rupture of membranes (RR = 3.14, 95% CI: 1.16-8.48) increased the risk of an SRS >3.
Interpretation: screening for EONS on the SRC could potentially reduce PAb usage by 68% in term and near-term neonates in level 2 neonatal units.
Text
Pediatric Investigation - 2022 - Fernandes - Screening for early‐onset neonatal sepsis on the Kaiser Permanente sepsis risk
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Accepted/In Press date: 27 July 2022
Published date: 24 August 2022
Identifiers
Local EPrints ID: 485809
URI: http://eprints.soton.ac.uk/id/eprint/485809
ISSN: 2574-2272
PURE UUID: 226d1dd1-f2b5-41db-95cc-0064ff6b8f2f
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Date deposited: 19 Dec 2023 18:00
Last modified: 18 Mar 2024 04:04
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Contributors
Author:
Michelle Fernandes
Author:
Lucinda Winckworth
Author:
Lyrille Lee
Author:
Madiha Akram
Author:
Simon Struthers
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