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Introduction: The SAGES Guidelines Committee creates evidence-based clinical practice guidelines (CPGs). Updates which incorporate new evidence into the guidelines are necessary to maintain relevance for clinical use. A description of our standard operating procedure for this process is described here, which contributes to SAGES' commitment to producing high-quality clinical recommendations., Methods: This paper outlines the SAGES Clinical Practice Guideline Update Standard Operating Procedure in order to incorporate regular updates to our guideline development process., Results: SAGES has developed an evidence-based, standardized approach in updating current clinical practice guidelines to ensure that physicians and patients have access to the most appropriate recommendations., Conclusion: Societies that promote guidelines within their organization must make an intentional effort to regularly evaluate the relevance of their recommendations. The SAGES Guidelines Update Standard Operating Procedure aims to provide a framework to reliably and systematically review existing guidelines and update them as needed., Competing Interests: Declarations. Disclosures: Elisa C. Calabrese is on a SAGE-ASERNIPS Evidence Guidance Research Scholarship. Bethany J. Slater is the SAGES Guidelines Committee chair and has received consulting fees from Hologic. Geoffrey P. Kohn has been paid for expert testimony by Avant Law. Tammy L. Kindel has grants with the NHLBI, NIA, and American College of Surgeons. She has received consulting fees from Ethicon J&J, leadership position at Treo Foundation, and patents (No. 63/505,036). Sunjay S. Kumar, Guy Maddern, and Wendy Babidge have no conflicts of interest to disclose., (© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Aim: To determine if any cases of culture-positive neonatal early-onset sepsis (EOS) would be missed using the neonatal EOS calculator, when compared with current guidelines and practices., Methods: Retrospective audit of all neonates born at ≥35 weeks and admitted to Royal Brisbane and Women's Hospital with EOS from January 2014 to December 2020. A missed case was defined as antibiotic therapy not being recommended within 24 h of birth. Management recommendations according to the neonatal EOS calculator were compared with current guidelines and current practices., Results: There were significantly more missed cases using the neonatal EOS calculator compared to the current guideline and current management groups. Using the neonatal EOS calculator, 11 neonates (35%, 95% confidence interval 19.2-54.6%) would not have received antibiotics by 24 h of age. In comparison, only one neonate (3%, 95% confidence interval 0.1-16.7%) would not have received antibiotics by 24 h of age using the current guidelines. In terms of the current practice in the cohort of patients, two neonates (6%) did not receive antibiotics by 24 h of age., Conclusions: The significantly higher rate of missed cases using the neonatal EOS calculator compared with current guidelines and practice supports the concerns many neonatologists have regarding safety of the neonatal EOS calculator., (© 2022 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).)