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The Management of Neonates ≥34 Weeks’ Gestation at Risk of Early Onset Sepsis: A Pilot Study

Early onset sepsis (EOS) is a potentially fatal condition in neonates, and its correct management is still challenging for neonatologists. Early antibiotic administration in the neonatal period may carry short- and long-term risks. Neonatal EOS calculator has been recently introduced as a new strate...

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Autores principales: Barbini, Maria Cristina, Perniciaro, Simona, Bresesti, Ilia, Folgori, Laura, Barcellini, Lucia, Bossi, Angela, Agosti, Massimo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10451212/
https://www.ncbi.nlm.nih.gov/pubmed/37627726
http://dx.doi.org/10.3390/antibiotics12081306
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author Barbini, Maria Cristina
Perniciaro, Simona
Bresesti, Ilia
Folgori, Laura
Barcellini, Lucia
Bossi, Angela
Agosti, Massimo
author_facet Barbini, Maria Cristina
Perniciaro, Simona
Bresesti, Ilia
Folgori, Laura
Barcellini, Lucia
Bossi, Angela
Agosti, Massimo
author_sort Barbini, Maria Cristina
collection PubMed
description Early onset sepsis (EOS) is a potentially fatal condition in neonates, and its correct management is still challenging for neonatologists. Early antibiotic administration in the neonatal period may carry short- and long-term risks. Neonatal EOS calculator has been recently introduced as a new strategy to manage infants at risk of sepsis, and has shown promising results. Methods: In this single-center observational retrospective study, 1000 neonates ≥ 34 weeks’ gestation were enrolled with the aim to evaluate our standard protocol for the management of suspected EOS compared to the EOS calculator. Outcome measures included the following: (1) incidence of EOS and (2) proportion of infants in need of sepsis evaluations and antibiotics using our standard protocol versus theoretical application of EOS calculator. Results: A total of 223/1000 infants underwent blood investigations versus 35/1000 (3.5%) if EOS calculator had been applied (p < 0.0001; k = 0.18). Furthermore, 48/1000 infants received antibiotics with our protocol versus 35/1000 with EOS calculator (p = 0.12; k = 0.58). Three infants had a positive blood culture that EOS calculator would have missed. Conclusions: In our study, EOS calculator could have reduced investigations but not antibiotic therapy. EOS calculator is an effective and promising tool, but further studies are required to improve it.
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spelling pubmed-104512122023-08-26 The Management of Neonates ≥34 Weeks’ Gestation at Risk of Early Onset Sepsis: A Pilot Study Barbini, Maria Cristina Perniciaro, Simona Bresesti, Ilia Folgori, Laura Barcellini, Lucia Bossi, Angela Agosti, Massimo Antibiotics (Basel) Article Early onset sepsis (EOS) is a potentially fatal condition in neonates, and its correct management is still challenging for neonatologists. Early antibiotic administration in the neonatal period may carry short- and long-term risks. Neonatal EOS calculator has been recently introduced as a new strategy to manage infants at risk of sepsis, and has shown promising results. Methods: In this single-center observational retrospective study, 1000 neonates ≥ 34 weeks’ gestation were enrolled with the aim to evaluate our standard protocol for the management of suspected EOS compared to the EOS calculator. Outcome measures included the following: (1) incidence of EOS and (2) proportion of infants in need of sepsis evaluations and antibiotics using our standard protocol versus theoretical application of EOS calculator. Results: A total of 223/1000 infants underwent blood investigations versus 35/1000 (3.5%) if EOS calculator had been applied (p < 0.0001; k = 0.18). Furthermore, 48/1000 infants received antibiotics with our protocol versus 35/1000 with EOS calculator (p = 0.12; k = 0.58). Three infants had a positive blood culture that EOS calculator would have missed. Conclusions: In our study, EOS calculator could have reduced investigations but not antibiotic therapy. EOS calculator is an effective and promising tool, but further studies are required to improve it. MDPI 2023-08-10 /pmc/articles/PMC10451212/ /pubmed/37627726 http://dx.doi.org/10.3390/antibiotics12081306 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Barbini, Maria Cristina
Perniciaro, Simona
Bresesti, Ilia
Folgori, Laura
Barcellini, Lucia
Bossi, Angela
Agosti, Massimo
The Management of Neonates ≥34 Weeks’ Gestation at Risk of Early Onset Sepsis: A Pilot Study
title The Management of Neonates ≥34 Weeks’ Gestation at Risk of Early Onset Sepsis: A Pilot Study
title_full The Management of Neonates ≥34 Weeks’ Gestation at Risk of Early Onset Sepsis: A Pilot Study
title_fullStr The Management of Neonates ≥34 Weeks’ Gestation at Risk of Early Onset Sepsis: A Pilot Study
title_full_unstemmed The Management of Neonates ≥34 Weeks’ Gestation at Risk of Early Onset Sepsis: A Pilot Study
title_short The Management of Neonates ≥34 Weeks’ Gestation at Risk of Early Onset Sepsis: A Pilot Study
title_sort management of neonates ≥34 weeks’ gestation at risk of early onset sepsis: a pilot study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10451212/
https://www.ncbi.nlm.nih.gov/pubmed/37627726
http://dx.doi.org/10.3390/antibiotics12081306
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