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Date Published: 17/02/2023
Abstract Views: 266
Views PDF: 121
DOI: https://doi.org/10.51298/vmj.v520i2.4161
Issue
Vol. 520 No. 2 (2022)
Section
Các bài báo
How to Cite
Nguyễn, T. H. O., & Nguyễn, T. T. (2023). THE COMPARISON OF RESULTS REASONABLE ANTIBIOTIC RECOMMENDATIONS BY THE NEONATAL EARLY ONSET RISK SEPSIS CALCULATOR OF KAISER VERSUS THE 2010 CDC GUIDELINES AT NEWBORNS ≥34 WEEKS OF GESTATION AGE BORN TO MOTHERS WITH CLINICAL CHORIOAMNIONITIS. Vietnam Medical Journal, 520(2). https://doi.org/10.51298/vmj.v520i2.4161

THE COMPARISON OF RESULTS REASONABLE ANTIBIOTIC RECOMMENDATIONS BY THE NEONATAL EARLY ONSET RISK SEPSIS CALCULATOR OF KAISER VERSUS THE 2010 CDC GUIDELINES AT NEWBORNS ≥34 WEEKS OF GESTATION AGE BORN TO MOTHERS WITH CLINICAL CHORIOAMNIONITIS

Thị Hoàng Oanh Nguyễn1, Thu Tịnh Nguyễn2,
1 Nguyen Dinh Chieu Hospital
2 University of Medicine and Pharmacy at Ho Chi Minh City

Main Article Content

Abstract

Background: Chorioamnionitis is the criterion used to indication antibiotics for infants after birth regardless of clinical symptoms or not. However, it is difficult to reach a histological diagnosis of chorioamnionitis. The criteria for “clinical choroiditis” are subjective, resulting in many healthy children being exposed to unnecessary antibiotics. Objective: To compare the proportion of reasonable antibiotic recommendations under the 2010 CDC guidelines versus a protocol based on a neonatal early-onset sepsis (NEOS) calculator developed by Kaiser Permanente in neonates at ≥34 weeks of gestation born to mothers with clinical  chorioamnionitis. Methods: Prospective follow-up study, newborns ≥34 weeks were born to mothers with clinical Chorioamnionitis at the Department of Obstetrics and Gynecology of Nguyen Dinh Chieu Hospital from November 1, 2021 to April 30, 2022. Observe and record clinical features of mother and child. Then, record antibiotic and antibiotic-free treatment recommendations under the 2010 CDC guidelines versus a protocol based on a neonatal early-onset sepsis (EOS) calculator developed by Kaiser Permanente. Results: 39 infants met the study criteria. All blood cultures were negative. The 2010 CDC guidelines recommend antibiotics for 39/39 (100%), while the early-onset sepsis (EOS) risk calculator of Kaiser recommends antibiotics for 14/39 (35.9%). In which, 5/39 (12.8%) were diagnosed with "early neonatal sepsis" and were recommended antibiotics immediately after birth by both. Conclusion: In newborns born to mothers with clinical Chorioamnionitis, the use of Kaiser's NEOS predictor resulted in a 64.1% reduction in the number of newborns receiving unnecessary antibiotics compared with the 2010 CDC guidelines. This calculator can be safely used in these cases. According to the study results, no newborn was "missed" by the calculator.

Article Details

Keywords

early onset sepsis, Early Onset Sepsis Calculator, The 2010 CDC guidelines, chorioamnionitis.

References

1. Carola D, Vasconcellos M, Sloane A, McElwee D, Edwards C, Greenspan J, et al. Utility of early-onset sepsis risk calculator for neonates born to mothers with chorioamnionitis. J Pediatr 2018; 195:48-52, e41.
2. Escobar GJ, Puopolo KM, Wi S, et al. Stratification of risk of early-onset sepsis in newborns ≥ 34 weeks’ gestation. Pediatrics 2014; 133: pp 30–36.
3. Gibbs, Ronald S.; Duff, Patrick. Progress in pathogenesis and management of clinical intraamniotic infection. American Journal of Obstetrics and Gynecology, 164(5), 1317–1326. doi:10.1016/0002-9378(91)90707-X
4. K. M. Puopolo, D. Draper, S. Wi, et al. Estimating the Probability of Neonatal Early-Onset Infection on the Basis of Maternal Risk Factors, Pediatrics, Vol. 128.
5. Modi N, Dore CJ, Saraswatula A, Richards M, Bamford KB, Coello R, et al. A case definition for National and International neonatal bloodstream infection surveillance. Arch Dis Child Fetal Neonatal Ed. 2009;94(1): F8–12.
6. Money N, Newman J, Demissie S, Roth P, Blau J. Anti-microbial stewardship: antibiotic use in well-appearing term neonates born to mothers with chorioamnionitis. J Perinatol. 2017 Dec;37(12): pp1304-1309.
7. Puopolo, Karen M., et al. Management of neonates born at≥ 35 0/7 weeks’ gestation with suspected or proven early-onset bacterial sepsis. Pediatrics, 2018, 142.6.
8. Verani JR, McGee L, Schrag SJ; Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC). Prevention of perinatal group B streptococcal disease--revised guidelines from CDC, 2010. MMWR Recomm Rep. 2010 Nov 19;59(RR-10):1-36.