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Screening for early onset neonatal sepsis: NICE guidance-based practice versus projected application of the Kaiser Permanente sepsis risk calculator in the UK population.
- Source :
- Archives of Disease in Childhood -- Fetal & Neonatal Edition; Mar2020, Vol. 105 Issue 2, pF118-F122, 5p
- Publication Year :
- 2020
-
Abstract
- <bold>Objective: </bold>To compare management recommendations of the National Institute for Health and Care Excellence (NICE) guidelines with the Kaiser Permanente sepsis risk calculator (SRC) for risk of early onset neonatal sepsis (EONS).<bold>Design: </bold>Multicentre prospective observational projection study.<bold>Setting: </bold>Eight maternity hospitals in Wales, UK.<bold>Patients: </bold>All live births ≥34 weeks gestation over a 3-month period (February-April 2018).<bold>Methods: </bold>Demographics, maternal and infant risk factors, infant's clinical status, antibiotic usage and blood culture results from first 72 hours of birth were collected. Infants were managed using NICE recommendations and decisions compared with that projected by SRC.<bold>Main Outcome Measure: </bold>Proportion of infants recommended for antibiotics on either tool.<bold>Results: </bold>Of 4992 eligible infants, complete data were available for 3593 (71.9%). Of these, 576 (16%) were started on antibiotics as per NICE recommendations compared with 156 (4.3%) projected by the SRC, a relative reduction of 74%. Of the 426 infants avoiding antibiotics, SRC assigned 314 (54.6%) to normal care only. There were seven positive blood cultures-three infants were recommended antibiotics by both, three were not identified in the asymptomatic stage by either; one was a contaminant. No EONS-related readmission was reported.<bold>Conclusion: </bold>The judicious adoption of SRC in UK clinical practice for screening and management of EONS could potentially reduce interventions and antibiotic usage in three out of four term or near-term infants and promote earlier discharge from hospital in >50%. We did not identify any EONS case missed by SRC when compared with NICE. These results have significant implications for healthcare resources. [ABSTRACT FROM AUTHOR]
- Subjects :
- NEONATAL sepsis
SEPSIS
CHILDBIRTH
HOSPITAL admission & discharge
NATIONAL health services
ANTIBIOTICS
RESEARCH
SPECIALTY hospitals
RESEARCH methodology
GESTATIONAL age
HEALTH status indicators
EVALUATION research
MEDICAL cooperation
SOCIOECONOMIC factors
MEDICAL protocols
RISK assessment
COMPARATIVE studies
QUESTIONNAIRES
LONGITUDINAL method
Subjects
Details
- Language :
- English
- ISSN :
- 13592998
- Volume :
- 105
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Archives of Disease in Childhood -- Fetal & Neonatal Edition
- Publication Type :
- Academic Journal
- Accession number :
- 141923967
- Full Text :
- https://doi.org/10.1136/archdischild-2018-316777