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01-05-2018 | Original Article

Sepsis calculator implementation reduces empiric antibiotics for suspected early-onset sepsis

Authors: Niek B. Achten, J. Wendelien Dorigo-Zetsma, Paul D. van der Linden, Monique van Brakel, Frans B. Plötz

Published in: European Journal of Pediatrics | Issue 5/2018

Abstract

Significant overtreatment with antibiotics for suspected early onset sepsis (EOS) constitutes a persisting clinical problem, generating unnecessary risks, harms, and costs for many newborns. We aimed to study feasibility and impact of a sepsis calculator to help guide antibiotic for suspected EOS in a European setting. In this single-center study, the sepsis calculator was implemented as an addition to and in accordance with existing protocols. One thousand eight hundred seventy-seven newborns ≥ 35 weeks of gestational age were prospectively evaluated; an analogous retrospective control group (n = 2076) was used for impact analysis. We found that empirical treatment with intravenous antibiotics for suspected EOS was reduced from 4.8 to 2.7% after sepsis calculator implementation (relative risk reduction 44% (95% confidence interval 21.4–59.5%)). No evidence for changes in time to treatment start, treatment duration, or proven sepsis rates was found. Adherence to sepsis calculator recommendation was 91%.

Conclusion: Pragmatic and feasible implementation of the sepsis calculator yields a 44% reduction of empirical use of antibiotics for EOS, without signs of delay or prolongation of treatment. These findings warrant a multicenter, nation-wide, randomized study evaluating systematic use of the sepsis calculator prediction model and its effects in clinical practice outside of the USA.

What is known:

• Significant overtreatment with antibiotics for suspected early-onset sepsis results in unnecessary costs, risks, and harms.

• Implementation of the sepsis calculator in the USA has resulted in a significant decrease in empirical antibiotic treatment, without apparent adverse events.

What is new:

• Implementation of the sepsis calculator in daily clinical decision-making in a Dutch teaching hospital is feasible in conjunction with existing protocols, with high adherence.

• Antibiotic therapy for suspected early-onset sepsis was reduced by 44% following implementation of the calculator.

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Title: Sepsis calculator implementation reduces empiric antibiotics for suspected early-onset sepsis
Authors: Niek B. Achten
J. Wendelien Dorigo-Zetsma
Paul D. van der Linden
Monique van Brakel
Frans B. Plötz
Publication date: 01-05-2018
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Pediatrics / Issue 5/2018
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-018-3113-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Sepsis calculator implementation reduces empiric antibiotics for suspected early-onset sepsis

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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