EOS

A Quantitative, Risk-Based Approach to the Management of Neonatal Early-Onset Sepsis

Early Onset Sepsis Early-onset sepsis (EOS) is a leading cause of neonatal death, but limited tools exist to accurately identify neonates with EOS and prevent those at low risk of EOS from unnecessary antibiotic exposure. This observational study assessed the use of an EOS calculator to modify antibiotic use and EOS workup in neonates > 35 weeks’ gestation at trial centers. The study demonstrated that use of the EOS calculator was associated with reduced evaluation for sepsis and reduced antibiotic use without increases in illness severity. Thus, use of the EOS calculator may be appropriate in the NICU.

Does a procalcitonin-guided approach to term and late-preterm neonates with suspected early-onset sepsis safely decrease unnecessary antibiotic exposure?

SEPSIS Suspected early-onset sepsis requires antibiotic administration and lengthened NICU stay. This randomized controlled trial studied the non-inferiority of using procalcitonin levels to determine appropriate antibiotic discontinuation in neonates with suspected or proven early-onset sepsis. While the trial was not powered to prove non-inferiority to standard antibiotic administration, the data demonstrated that procalcitonin-guided antibiotic decisions resulted in shorter antibiotic treatment. Thus, procalcitonin measurement may be useful in treatment decisions for neonates with suspected early-onset sepsis.