Hematologic scoring system (HSS): A guide to decide judicious use of antibiotics in neonatal septicemia in developing countries

Abstract

Background: Septicemia is one of the major causes of neonatal morbidity and mortality. Objective- The objective of our study was to determine the role of hematologic scoring system (HSS) in early diagnosis of neonatal septicemia and provide an effective guideline in decision making regarding judicious use of antibiotics. Materials and Methods: The study was done taking 60 neonates admitted in the hospital. The hematological parameters were studied in all of them. Blood cultures were performed as gold standard for diagnosing septicemia. Results: Analysis of the hematologic profiles in the light of the HSS found that an abnormal immature to total neutrophil (I:T) ratio followed by an abnormal immature to mature neutrophil (I:M) ratio were the most sensitive indicators in identifying infants with sepsis. The study also found that the higher the score the greater the certainty of sepsis being present. The score ≥ 4 was more reliable as a screening tool than any individual hematological parameter.Conclusion : HSS is rapid, easy to perform, cost-effective screening tool for early diagnosis of neonatal sepsis and thereby helps in making of decisions regarding judicious use of antibiotics.