Variation in Current Management of Term and Late-preterm Neonates at Risk for Early-onset Sepsis: An International Survey and Review of Guidelines

The Pediatric Infectious Disease Journal
Wendy van HerkMartin Stocker

Abstract

Uncertainty about the presence of infection results in unnecessary and prolonged empiric antibiotic treatment of newborns at risk for early-onset sepsis (EOS). This study evaluates the impact of this uncertainty on the diversity in management. A web-based survey with questions addressing management of infection risk-adjusted scenarios was performed in Europe, North America, and Australia. Published national guidelines (n = 5) were reviewed and compared with the results of the survey. 439 Clinicians (68% were neonatologists) from 16 countries completed the survey. In the low-risk scenario, 29% would start antibiotic therapy and 26% would not, both groups without laboratory investigations; 45% would start if laboratory markers were abnormal. In the high-risk scenario, 99% would start antibiotic therapy. In the low-risk scenario, 89% would discontinue antibiotic therapy before 72 hours. In the high-risk scenario, 35% would discontinue therapy before 72 hours, 56% would continue therapy for 5-7 days, and 9% for more than 7 days. Laboratory investigations were used in 31% of scenarios for the decision to start, and in 72% for the decision to discontinue antibiotic treatment. National guidelines differ considerably regarding the deci...Continue Reading

References

Jan 25, 2005·Health Services Research·William L CullSuk-fong S Tang
Apr 8, 2006·Current Opinion in Pediatrics·Pak C Ng, Hugh S Lam
Aug 3, 2006·Pediatrics·C Michael CottenUNKNOWN National Institute for Child Health and Human Development Neonatal Research Network
Oct 13, 2006·Journal of Tropical Pediatrics·G ChowdharyA Narang
Apr 3, 2008·Pediatrics·Bernt AlmGöran Wennergren
Dec 3, 2009·The Pediatric Infectious Disease Journal·Michael Cohen-WolkowiezP Brian Smith
Jun 24, 2010·Clinics in Perinatology·William E Benitz
Sep 30, 2010·Archives of Disease in Childhood. Fetal and Neonatal Edition·Stefania VergnanoPaul T Heath
Apr 15, 2011·The Journal of Pediatrics·Vanaja N AlexanderMatthew J Bizzarro
Apr 27, 2011·Pediatrics·Barbara J StollUNKNOWN Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
Jun 10, 2011·The Pediatric Infectious Disease Journal·Emily J WestonStephanie J Schrag
Jul 20, 2011·Acta Paediatrica·Emma GoksörGöran Wennergren
Jul 26, 2011·The Journal of Pediatrics·Venkata S KuppalaKurt R Schibler
Nov 17, 2011·Critical Care : the Official Journal of the Critical Care Forum·Thomas C HaveyNick Daneman
May 2, 2012·Pediatrics·Richard A Polin, UNKNOWN Committee on Fetus and Newborn
May 15, 2012·Lancet·Li LiuUNKNOWN Child Health Epidemiology Reference Group of WHO and UNICEF
Jul 21, 2012·Journal of Perinatology : Official Journal of the California Perinatal Association·S MukhopadhyayK M Puopolo
Jun 12, 2013·Pediatrics·Michael T Brady, Richard A Polin
Dec 18, 2013·The Journal of Pediatrics·Michel MikhaelCharles R Rosenfeld
Dec 25, 2013·Pediatrics·Gabriel J EscobarDavid Draper
May 7, 2014·Pediatrics·Courtney KiserZubair H Aghai
Jul 19, 2014·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Alberto BerardiFabrizio Ferrari
Jul 22, 2014·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Alan R Schroeder, Shawn L Ralston
Aug 1, 2014·Archives of Disease in Childhood. Fetal and Neonatal Edition·Arindam MukherjeeNigel Kennea
Nov 27, 2014·Archives of Disease in Childhood. Fetal and Neonatal Edition·A R Bedford Russell, R Kumar

❮ Previous
Next ❯

Citations

Apr 20, 2017·Journal of Paediatrics and Child Health·Jeremy P CarrJim P Buttery
Dec 10, 2016·Acta Paediatrica·Martin DragesetClaus Klingenberg
Feb 8, 2018·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Debby Bogaert, Alex van Belkum
May 25, 2018·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Luca BedettiAlberto Berardi
Jan 25, 2019·The Journal of Perinatal & Neonatal Nursing·Ashley R HelmbrechtHala Chaaban
Jun 30, 2018·Italian Journal of Pediatrics·Alberto BerardiUNKNOWN GBS Prevention Working Group of Emilia-Romagna
Aug 30, 2018·Computational and Mathematical Methods in Medicine·YuXiu MengLiPei Wang
Jun 10, 2017·Frontiers in Pediatrics·Nelly AmenyogbeRym Ben-Othman
Jan 1, 2019·Current Emergency and Hospital Medicine Reports·Muhammed ErshadDavid Vearrier
Aug 10, 2020·Journal of Perinatal Medicine·Naveed Ur Rehman DurraniEnas El Gouhary
Dec 21, 2020·American Journal of Perinatology·Ligia Maria Suppo de Souza RugoloGary M Weiner
Jan 16, 2021·Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie·C SchmittJ-M Hascoët
Feb 17, 2021·Journal of Paediatrics and Child Health·Alexandra Cussen, Lorna Guinness
Oct 22, 2021·Critical Care : the Official Journal of the Critical Care Forum·A J L M GeraerdsSuzanne Polinder
Jun 5, 2021·Hospital Pediatrics·Kurlen S E PaytonPaul J Sharek
Feb 10, 2017·Pediatrics·Sagori MukhopadhyayKaren M Puopolo

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.