Retrospective cohort study of neonatal early onset of sepsis and the role of the EOS calculator in a level II nurseryWhat is known?What is new?What is significant for clinical practice?
Background: Sepsis is a major cause of mortality and morbidity in neonates. With the improvement in health care standards, the incidence of neonatal Early Onset Sepsis (EOS) has reduced significantly. A recent Web-based EOS-calculator has been introduced with the aim to reduce the use of IV antibiot...
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| Format: | Article |
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Elsevier
2021-09-01
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| Series: | Pediatrics and Neonatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957221000851 |
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| author | Chia Saw Karthik Kulasekaran Dhanushke Thilan Fernando Darren Tan Raghu Dharmapuri Max K. Bulsara Noel David Friesen |
| author_facet | Chia Saw Karthik Kulasekaran Dhanushke Thilan Fernando Darren Tan Raghu Dharmapuri Max K. Bulsara Noel David Friesen |
| author_sort | Chia Saw |
| collection | DOAJ |
| description | Background: Sepsis is a major cause of mortality and morbidity in neonates. With the improvement in health care standards, the incidence of neonatal Early Onset Sepsis (EOS) has reduced significantly. A recent Web-based EOS-calculator has been introduced with the aim to reduce the use of IV antibiotics in neonates. The role of the EOS-calculator has yet to be ascertained in this regional Special Care Nursery (SCN) in Western Australia. This study aims at examining the local incidence of culture proven EOS and the role of the EOS calculator. Method: It is a retrospective study examining all newborns ≥35 weeks gestation throughout 2019 (Jan–Dec 2019) who received IV-antibiotics. The local incidence of culture-proven EOS was established and applied onto the EOS calculator. The recommended management by the EOS-calculator was cross-examined with the local EOS guideline. Overall proportion of reduction in IV antibiotics use was formulated. Other relevant laboratory data extracted was analysed with Pearson's correlation test with the EOS scores. Results: Total included sample was n = 252 with an annual birth of 1880s indicating 13.4% of all neonates born throughout year 2019 was treated with IV antibiotics. The local incidence of culture-proven EOS was 0.5/1000. By applying the EOS-calculator, a significant reduction of IV antibiotics usage from 13.4% to 3.9% (z value 10.4, p < 0.0001) could be achieved in this cohort. Sixty three percent of neonates who received IV antibiotics in this cohort were classified as ‘clinically well’ based on the EOS-calculator. Conclusion: The EOS-calculator could reduce the use of IV antibiotics in the neonatal population significantly in this regional SCN (from 13.4% to 3.9%). Judicial use of IV antibiotics is imperative as part of the holistic care for the neonates. Implementation of the EOS-calculator must be done strategically considering the local incidence of EOS and other health care policies. |
| format | Article |
| id | doaj-art-36d1c87698d341aaabe0384f03e1a3b7 |
| institution | OA Journals |
| issn | 1875-9572 |
| language | English |
| publishDate | 2021-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj-art-36d1c87698d341aaabe0384f03e1a3b72025-08-20T02:01:41ZengElsevierPediatrics and Neonatology1875-95722021-09-0162551252110.1016/j.pedneo.2021.05.005Retrospective cohort study of neonatal early onset of sepsis and the role of the EOS calculator in a level II nurseryWhat is known?What is new?What is significant for clinical practice?Chia Saw0Karthik Kulasekaran1Dhanushke Thilan Fernando2Darren Tan3Raghu Dharmapuri4Max K. Bulsara5Noel David Friesen6SJOG Midland Public Hospital, Australia; Corresponding author.SJOG Midland Public Hospital, AustraliaSJOG Midland Public Hospital, AustraliaSJOG Midland Public Hospital, AustraliaSJOG Midland Public Hospital, AustraliaUWA School of Population Health, AustraliaSJOG Midland Public Hospital, AustraliaBackground: Sepsis is a major cause of mortality and morbidity in neonates. With the improvement in health care standards, the incidence of neonatal Early Onset Sepsis (EOS) has reduced significantly. A recent Web-based EOS-calculator has been introduced with the aim to reduce the use of IV antibiotics in neonates. The role of the EOS-calculator has yet to be ascertained in this regional Special Care Nursery (SCN) in Western Australia. This study aims at examining the local incidence of culture proven EOS and the role of the EOS calculator. Method: It is a retrospective study examining all newborns ≥35 weeks gestation throughout 2019 (Jan–Dec 2019) who received IV-antibiotics. The local incidence of culture-proven EOS was established and applied onto the EOS calculator. The recommended management by the EOS-calculator was cross-examined with the local EOS guideline. Overall proportion of reduction in IV antibiotics use was formulated. Other relevant laboratory data extracted was analysed with Pearson's correlation test with the EOS scores. Results: Total included sample was n = 252 with an annual birth of 1880s indicating 13.4% of all neonates born throughout year 2019 was treated with IV antibiotics. The local incidence of culture-proven EOS was 0.5/1000. By applying the EOS-calculator, a significant reduction of IV antibiotics usage from 13.4% to 3.9% (z value 10.4, p < 0.0001) could be achieved in this cohort. Sixty three percent of neonates who received IV antibiotics in this cohort were classified as ‘clinically well’ based on the EOS-calculator. Conclusion: The EOS-calculator could reduce the use of IV antibiotics in the neonatal population significantly in this regional SCN (from 13.4% to 3.9%). Judicial use of IV antibiotics is imperative as part of the holistic care for the neonates. Implementation of the EOS-calculator must be done strategically considering the local incidence of EOS and other health care policies.http://www.sciencedirect.com/science/article/pii/S1875957221000851antibioticsEOSneonatessepsistherapy |
| spellingShingle | Chia Saw Karthik Kulasekaran Dhanushke Thilan Fernando Darren Tan Raghu Dharmapuri Max K. Bulsara Noel David Friesen Retrospective cohort study of neonatal early onset of sepsis and the role of the EOS calculator in a level II nurseryWhat is known?What is new?What is significant for clinical practice? Pediatrics and Neonatology antibiotics EOS neonates sepsis therapy |
| title | Retrospective cohort study of neonatal early onset of sepsis and the role of the EOS calculator in a level II nurseryWhat is known?What is new?What is significant for clinical practice? |
| title_full | Retrospective cohort study of neonatal early onset of sepsis and the role of the EOS calculator in a level II nurseryWhat is known?What is new?What is significant for clinical practice? |
| title_fullStr | Retrospective cohort study of neonatal early onset of sepsis and the role of the EOS calculator in a level II nurseryWhat is known?What is new?What is significant for clinical practice? |
| title_full_unstemmed | Retrospective cohort study of neonatal early onset of sepsis and the role of the EOS calculator in a level II nurseryWhat is known?What is new?What is significant for clinical practice? |
| title_short | Retrospective cohort study of neonatal early onset of sepsis and the role of the EOS calculator in a level II nurseryWhat is known?What is new?What is significant for clinical practice? |
| title_sort | retrospective cohort study of neonatal early onset of sepsis and the role of the eos calculator in a level ii nurserywhat is known what is new what is significant for clinical practice |
| topic | antibiotics EOS neonates sepsis therapy |
| url | http://www.sciencedirect.com/science/article/pii/S1875957221000851 |
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