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Ellington M, Kasat K, Williams K, et al. Improving Antibiotic Stewardship among Asymptomatic Newborns Using the Early-onset Sepsis Risk Calculator. Pediatr Qual Saf. 2021;6(5):e459doi: 10.1097/pq9.0000000000000459.
Ellington, M., Kasat, K., Williams, K., Reichman, V., Stoffels, G., Ming Leung, T., Degoy, A., Fisk, R., Gonzalez-Ballesteros, L., Peralta-Reich, D., Potash, A., & Rao, K. (2021). Improving Antibiotic Stewardship among Asymptomatic Newborns Using the Early-onset Sepsis Risk Calculator. Pediatric quality & safety, 6(5), e459. https://doi.org/10.1097/pq9.0000000000000459
Ellington, Marty, et al. "Improving Antibiotic Stewardship among Asymptomatic Newborns Using the Early-onset Sepsis Risk Calculator." Pediatric quality & safety vol. 6,5 (2021): e459. doi: https://doi.org/10.1097/pq9.0000000000000459
Ellington M, Kasat K, Williams K, Reichman V, Stoffels G, Ming Leung T, Degoy A, Fisk R, Gonzalez-Ballesteros L, Peralta-Reich D, Potash A, Rao K. Improving Antibiotic Stewardship among Asymptomatic Newborns Using the Early-onset Sepsis Risk Calculator. Pediatr Qual Saf. 2021 Aug 26;6(5):e459. doi: 10.1097/pq9.0000000000000459. eCollection 2021. PMID: 34476311; PMCID: PMC8389914.
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Pediatr Qual Saf. 2021 Aug 26;6(5):e459. doi: 10.1097/pq9.0000000000000459. eCollection 2021.

Improving Antibiotic Stewardship among Asymptomatic Newborns Using the Early-onset Sepsis Risk Calculator.

Pediatric quality & safety

Marty Ellington, Kavita Kasat, Kim Williams, Victoria Reichman, Guillaume Stoffels, Tung Ming Leung, Ana Degoy, Rebecca Fisk, Luisa Gonzalez-Ballesteros, Dinabel Peralta-Reich, Aaron Potash, Kavya Rao

Affiliations

  1. Lenox Hill Hospital, New York, N.Y.
  2. Zucker School of Medicine at Hofstra/Northwell.

PMID: 34476311 PMCID: PMC8389914 DOI: 10.1097/pq9.0000000000000459

Abstract

INTRODUCTION: Neonatologists have long struggled with identifying and treating early-onset sepsis (EOS) without overexposing newborns to unnecessary antibiotics.

METHODS: In January 2016, we instituted an EOS protocol based mainly on the 2012 AAP guidelines. We subsequently conducted 2 additional plan-do-study-act cycles to decrease antibiotic usage by integrating the EOS risk calculator into our algorithm. For the periods January 2016-June 2017 (period 1), June 2017-February 2018 (period 2), and February 2018-December 2018 (period 3), we tracked all asymptomatic newborns older than 36 weeks, including those admitted to the neonatal intensive care unit for evaluation of EOS. We monitored the monthly variation in asymptomatic newborns older than 36 weeks who received antibiotics using statistical process control. The number of asymptomatic infants treated with antibiotics during the 3 periods was analyzed. Pairwise comparisons were made using post hoc chi-square analysis.

RESULTS: The addition of the EOS calculator score to our guidelines reduced the number of asymptomatic infants older than 36 weeks treated with antibiotics by 73% (

CONCLUSIONS: The addition of the EOS calculator score to our AAP-based guidelines reduced antibiotic use among asymptomatic infants older than 36 weeks by 73%. Further adoption of the EOS calculator score after the clinical examination enabled our team to defer antibiotics in almost all asymptomatic infants safely.

Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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