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