Reducing Antibiotic Use in Infants With Use of Sepsis Risk Calculator
Antibiotic administration lowered from an average of 7.5% of newborns per month to 2.6% of newborns per month after using the sepsis calculator.
The use of an early-onset sepsis calculator can help decrease the number of infants who receive a sepsis work-up and prophylactic antibiotics due to a maternal diagnosis of chorioamnionitis, according to data presented at the 2017 national conference of the National Association of Pediatric Nurse Practitioners (NAPNAP).
Recent data suggest that many infants with sepsis risk factors may be able to avoid exposure to antibiotics by using objective perinatal parameters to assess the infant's individual risk for sepsis. Emily Freeman, MSN, CPNP, and Carl Seashore, MD, from Kaiser Permanente initiated the use of the Kaiser Permanente Neonatal Early-Onset Sepsis calculator among infants at risk for sepsis on the basis of a maternal diagnosis of chorioamnionitis.
The calculator determines the risk of sepsis using gestational age, highest maternal temperature, GBS status, and if antibiotics were given to the mother during labor. The infant's risk is calculated after the information is entered into the tool, and the risk is further stratified based on the infant's clinical appearance. The researchers note that recommendations for treatment of the infant vary based on the category consistent with the infant's examination.
The investigators found that the antibiotic administration rate in the newborn nursery at Kaiser Permanente decreased from an average of 7.5% of newborns per month to an average of 2.6% of newborns per month after the initiation of the sepsis calculator in March 2016. Since the initiation of this tool, the facility has had no readmissions for sepsis in infants born to mothers with chorioamnionitis.
“Widespread adaption of this tool in combination with appropriate clinical assessment has the potential to significantly decrease antibiotic exposure in newborns, decrease unnecessary painful procedures, decrease health care associated costs, and promote breastfeeding by decreasing unnecessary separation of mother and infant,” the authors concluded.
Freeman E, Seashore C. Implementation of new tools in the evaluation and management of newborns at risk for sepsis. Presented at: National Association of Pediatric Nurse Practitioners. Denver, CO; March 16-19, 2017. Poster TH-11.