The neonatal early-onset sepsis calculator to reduce empiric antibiotic use in newborns exposed to chorioamnionitis

Abstract

BackgroundTerm and late preterm newborns exposed to maternal chorioamnionitis (CAM) have traditionally received early-onset sepsis (EOS) evaluations and empiric antibiotics despite their clinical appearance leading to ineffective maternal/infant bonding, NICU admissions and unnecessary antibiotic exposure. MethodsPre/post-interventional quality improvement project in a level III NICU to reduce empiric antibiotic therapy and EOS evaluations in newborns exposed to CAM using the Neonatal Early-Onset Sepsis (NEOS) Calculator. ResultsMean empiric antibiotic treatment days for newborns exposed to CAM during the pre-implementation period was 3.14 days and 1.33 days during post-implementation period, an 81% reduction. A 16.7% reduction in EOS evaluations between the pre- and post-implementation periods was noted. Antibiotic use in newborns exposed to CAM decreased from 100% during the pre-implementation data collection to 41.7%. DiscussionThe NEOS calculator may reduce unnecessary antibiotic use and diagnostic testing in newborns exposed to CAM while lowering healthcare expenditures in the assessment of EOS in newborns. ConclusionsThese findings emphasize the importance of implementing an evidence-based protocol for newborns exposed to CAM.