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http://hdl.handle.net/10553/135580
Title: | Improved efficiency in the management of newborns with infectious risk factors by the sepsis risk calculator and clinical observation | Authors: | Mazabanda López, Diego Andrés Urquia Martí, Lourdes Reyes Suárez, Desiderio Zacarías Siguero Onrubia, Marta Borges Luján, Moreyba García-Muñoz Rodrigo, Fermín |
UNESCO Clasification: | 32 Ciencias médicas 320110 Pediatría |
Keywords: | Antibiotic therapy Early-onset neonatal sepsis Infectious risk factors Maternal chorioamnionitis Sepsis workup |
Issue Date: | 2024 | Journal: | Jornal de Pediatria | Abstract: | Objective: To evaluate the efficiency of the sepsis risk calculator and the serial clinical observation in the management of late preterm and term newborns with infectious risk factors. Method: Single-center, observational, two-phase cohort study comparing the rates of neonates born ≥35 weeks' gestation, ≥2000 g birthweight, and without major congenital anomalies, who were screened and/or received antibiotics for early-onset neonatal sepsis risk at our center during two periods, before (January/2018–June/2019) and after (July/2019–December/2020) the implementation of the sepsis risk calculator. Results: A total of 1796 (Period 1) and 1867 (Period 2) patients with infectious risk factors were included. During the second period, tests to rule out sepsis were reduced by 34.0 % (RR, 95 %CI): 0.66 (0.61, 0.71), blood cultures by 13.1 %: 0.87 (0.77, 0.98), hospital admissions by 13.5 %: 0.86 (0.76, 0.98) and antibiotic administration by 45.9 %: 0.54 (0.47, 0.63). Three cases of early-onset neonatal sepsis occurred in the first period and two in the second. Clinical serial evaluation would have detected all true cases. Conclusions: The implementation of a sepsis risk calculator in the management of newborns ≥35 weeks GA, ≥2000 g birthweight, without major congenital anomalies, with infectious risk factors is safe and adequate to reduce laboratory tests, blood cultures, hospital admissions, and antibiotics administration. Serial clinical observation, in addition, could be instrumental to achieve or even improve this goal. | URI: | http://hdl.handle.net/10553/135580 | ISSN: | 0021-7557 | DOI: | 10.1016/j.jped.2023.07.008 | Source: | Jornal De Pediatria[ISSN 0021-7557],v. 100(1), pp. 100-107 (Enero-febrero 2024) |
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