Antibiotic Treatment for Well-Appearing Infants Born at ≥35 Weeks’ Gestation to Mothers with Chorioamnionitis Before and After Implementation of Neonatal Early-Onset Sepsis Calculator
Purpose: Our quality improvement study aimed to determine whether application of a neonatal early-onset sepsis calculator (NSC) among well-appearing infants born at ≥ 35 weeks’ gestation to mothers with chorioamnionitis decreases the number of lab evaluations (LEs) and antibiotic treatments (Abxs...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Advocate Aurora Health
2024-04-01
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| Series: | Journal of Patient-Centered Research and Reviews |
| Subjects: | |
| Online Access: | https://institutionalrepository.aah.org/cgi/viewcontent.cgi?article=2005&context=jpcrr |
| _version_ | 1797224542496620544 |
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| author | Surichhya Bajracharya Preetha Prazad Catherine Bennett Nahren Asado |
| author_facet | Surichhya Bajracharya Preetha Prazad Catherine Bennett Nahren Asado |
| author_sort | Surichhya Bajracharya |
| collection | DOAJ |
| description | Purpose:
Our quality improvement study aimed to determine whether application of a neonatal early-onset sepsis calculator (NSC) among well-appearing infants born at ≥ 35 weeks’ gestation to mothers with chorioamnionitis decreases the number of lab evaluations (LEs) and antibiotic treatments (Abxs) without missing early-onset sepsis.
Methods:
We compared 2 years (January 1, 2019–January 3, 2021) of data from a historical-control group before implementation of the NSC to 1 year (January 4, 2021–December 31, 2021) of data from a calculator group after implementation of the NSC to evaluate whether LE and Abx decreased following implementation of the NSC on January 4, 2021. A P-value of < 0.05 was considered statistically significant for the chi-squared test, Fisher’s exact test, Student’s t-test, and Mann-Whitney U test used for the analyses.
Results:
In the historical-control group, 94% of infants received LE and Abx. Retrospective application of the NSC in the historical-control group decreased LE from 94% to 21% and Abx from 94% to 13%. In the calculator group, 14% and 5% of infants received LE and Abx, respectively, and none of the blood culture was positive. Median time from birth to antibiotic initiation was significantly longer (14.5 vs 3.8 hours; P = 0.0037) with no increase in median length of stay (2.3 vs 2.4 days; P = 0.02) after NSC implementation. No significant difference in neonatal intensive care unit admission was identified between groups (4% vs 1%; P = 0.15).
Conclusions:
There was a significant decrease in LE and Abx among well-appearing infants born at ≥ 35 weeks’ gestation to mothers with chorioamnionitis after implementation of the NSC without missing early-onset sepsis. There was no increase in neonatal intensive care unit admission or length of hospital stay in infants who received antibiotics later after they appeared equivocal or clinically ill in the calculator group. Larger prospective studies that include follow ups are needed to confirm that early-onset sepsis is not missed. (J Patient Cent Res Rev. 2024;11:29-35.) |
| first_indexed | 2024-04-24T13:54:46Z |
| format | Article |
| id | doaj.art-83a7a80044834c2caca77968884430cb |
| institution | Directory Open Access Journal |
| issn | 2330-0698 |
| language | English |
| last_indexed | 2024-04-24T13:54:46Z |
| publishDate | 2024-04-01 |
| publisher | Advocate Aurora Health |
| record_format | Article |
| series | Journal of Patient-Centered Research and Reviews |
| spelling | doaj.art-83a7a80044834c2caca77968884430cb2024-04-03T19:24:19ZengAdvocate Aurora HealthJournal of Patient-Centered Research and Reviews2330-06982024-04-01111293510.17294/2330-0698.2005Antibiotic Treatment for Well-Appearing Infants Born at ≥35 Weeks’ Gestation to Mothers with Chorioamnionitis Before and After Implementation of Neonatal Early-Onset Sepsis CalculatorSurichhya Bajracharya0Preetha Prazad1https://orcid.org/0000-0001-9120-4575Catherine Bennett2Nahren Asado3Neonatal Perinatal Medicine, Advocate Children’s Hospital, Park Ridge, ILNeonatal Perinatal Medicine, Advocate Children’s Hospital, Park Ridge, ILObstetrics and Gynecology, Advocate Lutheran General Hospital, Park Ridge, ILPathology, Advocate Lutheran General Hospital, Park Ridge, ILPurpose: Our quality improvement study aimed to determine whether application of a neonatal early-onset sepsis calculator (NSC) among well-appearing infants born at ≥ 35 weeks’ gestation to mothers with chorioamnionitis decreases the number of lab evaluations (LEs) and antibiotic treatments (Abxs) without missing early-onset sepsis. Methods: We compared 2 years (January 1, 2019–January 3, 2021) of data from a historical-control group before implementation of the NSC to 1 year (January 4, 2021–December 31, 2021) of data from a calculator group after implementation of the NSC to evaluate whether LE and Abx decreased following implementation of the NSC on January 4, 2021. A P-value of < 0.05 was considered statistically significant for the chi-squared test, Fisher’s exact test, Student’s t-test, and Mann-Whitney U test used for the analyses. Results: In the historical-control group, 94% of infants received LE and Abx. Retrospective application of the NSC in the historical-control group decreased LE from 94% to 21% and Abx from 94% to 13%. In the calculator group, 14% and 5% of infants received LE and Abx, respectively, and none of the blood culture was positive. Median time from birth to antibiotic initiation was significantly longer (14.5 vs 3.8 hours; P = 0.0037) with no increase in median length of stay (2.3 vs 2.4 days; P = 0.02) after NSC implementation. No significant difference in neonatal intensive care unit admission was identified between groups (4% vs 1%; P = 0.15). Conclusions: There was a significant decrease in LE and Abx among well-appearing infants born at ≥ 35 weeks’ gestation to mothers with chorioamnionitis after implementation of the NSC without missing early-onset sepsis. There was no increase in neonatal intensive care unit admission or length of hospital stay in infants who received antibiotics later after they appeared equivocal or clinically ill in the calculator group. Larger prospective studies that include follow ups are needed to confirm that early-onset sepsis is not missed. (J Patient Cent Res Rev. 2024;11:29-35.)https://institutionalrepository.aah.org/cgi/viewcontent.cgi?article=2005&context=jpcrrneonatalearly-onset sepsiscalculatorchorioamnioitis |
| spellingShingle | Surichhya Bajracharya Preetha Prazad Catherine Bennett Nahren Asado Antibiotic Treatment for Well-Appearing Infants Born at ≥35 Weeks’ Gestation to Mothers with Chorioamnionitis Before and After Implementation of Neonatal Early-Onset Sepsis Calculator Journal of Patient-Centered Research and Reviews neonatal early-onset sepsis calculator chorioamnioitis |
| title | Antibiotic Treatment for Well-Appearing Infants Born at ≥35 Weeks’ Gestation to Mothers with Chorioamnionitis Before and After Implementation of Neonatal Early-Onset Sepsis Calculator |
| title_full | Antibiotic Treatment for Well-Appearing Infants Born at ≥35 Weeks’ Gestation to Mothers with Chorioamnionitis Before and After Implementation of Neonatal Early-Onset Sepsis Calculator |
| title_fullStr | Antibiotic Treatment for Well-Appearing Infants Born at ≥35 Weeks’ Gestation to Mothers with Chorioamnionitis Before and After Implementation of Neonatal Early-Onset Sepsis Calculator |
| title_full_unstemmed | Antibiotic Treatment for Well-Appearing Infants Born at ≥35 Weeks’ Gestation to Mothers with Chorioamnionitis Before and After Implementation of Neonatal Early-Onset Sepsis Calculator |
| title_short | Antibiotic Treatment for Well-Appearing Infants Born at ≥35 Weeks’ Gestation to Mothers with Chorioamnionitis Before and After Implementation of Neonatal Early-Onset Sepsis Calculator |
| title_sort | antibiotic treatment for well appearing infants born at ≥35 weeks gestation to mothers with chorioamnionitis before and after implementation of neonatal early onset sepsis calculator |
| topic | neonatal early-onset sepsis calculator chorioamnioitis |
| url | https://institutionalrepository.aah.org/cgi/viewcontent.cgi?article=2005&context=jpcrr |
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