Should we give antibiotics to neonates with mild non-progressive symptoms? A comparison of serial clinical observation and the neonatal sepsis risk calculator.
early-onset sepsis
neonatal early-onset sepsis calculator
neonates
newborn
perinatal distress
serial clinical observation
Journal
Frontiers in pediatrics
ISSN: 2296-2360
Titre abrégé: Front Pediatr
Pays: Switzerland
ID NLM: 101615492
Informations de publication
Date de publication:
2022
2022
Historique:
received:
23
02
2022
accepted:
30
06
2022
entrez:
15
8
2022
pubmed:
16
8
2022
medline:
16
8
2022
Statut:
epublish
Résumé
To compare two strategies [the neonatal sepsis risk calculator (NSC) and the updated serial clinical observation approach (SCO)] for the management of asymptomatic neonates at risk of early-onset sepsis (EOS) and neonates with mild non-progressive symptoms in the first hours of life. This was a single-center, retrospective cohort study conducted over 15 months (01/01/2019-31/03/2020). All live births at ≥34 weeks of gestation were included. Infants were managed using SCO and decisions were compared with those retrospectively projected by the NSC. The proportion of infants recommended for antibiotics or laboratory testing was compared in both strategies. McNemar's non-parametric test was used to assess significant differences in matched proportions. Among the 3,445 neonates (late-preterm, SCO minimizes laboratory testing and unnecessary antibiotics in infants at risk of EOS or with mild non-progressive symptoms, without the risk of a worse neonatal outcome. The NSC recommends almost three times more antibiotics than the SCO without improving neonatal outcomes.
Identifiants
pubmed: 35967559
doi: 10.3389/fped.2022.882416
pmc: PMC9364607
doi:
Types de publication
Journal Article
Langues
eng
Pagination
882416Informations de copyright
Copyright © 2022 Berardi, Zinani, Bedetti, Vaccina, Toschi, Toni, Lecis, Leone, Monari, Cozzolino, Zini, Boncompagni, Iughetti, Miselli and Lugli.
Références
J Perinatol. 2021 Oct;41(10):2488-2494
pubmed: 34103671
J Med Screen. 2011;18(2):60-4
pubmed: 21852697
Pediatrics. 2018 Dec;142(6):
pubmed: 30455342
Expert Rev Anti Infect Ther. 2020 Jan;18(1):37-46
pubmed: 31762370
Hosp Pediatr. 2022 Jan 1;12(1):16-21
pubmed: 34935049
Jt Comm J Qual Patient Saf. 2016 May;42(5):232-9
pubmed: 27066927
JAMA Pediatr. 2019 Nov 01;173(11):1032-1040
pubmed: 31479103
JAMA Pediatr. 2017 Apr 1;171(4):365-371
pubmed: 28241253
Lancet Infect Dis. 2021 May;21(5):e134-e140
pubmed: 33129425
J Pediatr. 2015 Apr;166(4):1070-4
pubmed: 25641240
Clin Perinatol. 2010 Jun;37(2):421-38
pubmed: 20569816
J Matern Fetal Neonatal Med. 2015 Jul;28(10):1123-7
pubmed: 25034325
MMWR Recomm Rep. 2010 Nov 19;59(RR-10):1-36
pubmed: 21088663
J Matern Fetal Neonatal Med. 2016 Oct;29(19):3126-31
pubmed: 26515917
Semin Fetal Neonatal Med. 2021 Jun;26(3):101217
pubmed: 33678550
J Pediatr. 1966 Aug;69(2):193-7
pubmed: 5946646
J Matern Fetal Neonatal Med. 2020 Mar;33(6):1036-1043
pubmed: 30058404
Pediatrics. 2014 Feb;133(2):196-203
pubmed: 24446442
Pediatrics. 2018 Apr;141(4):
pubmed: 29599112
J Perinatol. 2018 Jun;38(6):614-622
pubmed: 29483569
Curr Opin Pediatr. 2020 Apr;32(2):245-251
pubmed: 31851052
EClinicalMedicine. 2020 Jan 26;19:100255
pubmed: 32140673
Pediatr Infect Dis J. 2016 May;35(5):494-500
pubmed: 26766143
Pediatrics. 2004 Aug;114(2):372-6
pubmed: 15286219