Please use this identifier to cite or link to this item: 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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