Early-onset sepsis: a cohort study comparing serial clinical observation with laboratory testing

Autores de IIS La Fe

• Anna Parra Llorca

  Autor

• Juan Diego Toledo Parreño

  Autor

Participantes ajenos a IIS La Fe

• Garcia, SS
• Ruescas, BV
• Zabaleta, MA
• Garcia, SL

Grupos

• Perinatología

  

  Leader

  Máximo Vento Torres

Abstract

Objective Early onset sepsis (EOS) remains a serious and potentially fatal illness. We aimed to demonstrate that serial clinical observation (SCO) is a feasible strategy associated with fewer laboratory evaluations and unnecessary antibiotic use. Study design We compared the admissions and antibiotic therapy in neonates >= 35 weeks' gestation at risk for EOS in a prospective cohort after the implementation of a new protocol based on SCO (n = 381) with a historical cohort which received laboratory testing (n = 417). Results There was a significant reduction in admissions for suspected sepsis (7.2% vs 2.9%, p = 0.006) and the use of antibiotics (6.1% vs 0.7%, p = 0.000) in the cohort based on SCO. There was no delay in diagnosis. Conclusions SCO in neonates >= 35 weeks' gestation at risk for EOS, including chorioamnionitis-exposed infants, is a feasible measure that reduces laboratory evaluations and the overuse of antibiotics respecting the bonding mother-infant.

Keywords

• C-REACTIVE PROTEIN; NEONATAL SEPSIS; VERTICAL TRANSMISSION; PHYSICAL-EXAMINATION; MANAGEMENT; RISK; INFANTS; PREVENTION; NEWBORNS