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.

Randomized Controlled Trial of Lactoferrin for Prevention of Sepsis in Peruvian Neonates Less than 2500g

SEPSIS Late-onset sepsis is a common and severe neonatal morbidity. This randomized controlled trial studied the effectiveness of lactoferrin in preventing late-onset sepsis among infants <2500 grams. This study showed no significant difference in the incidence of late-onset sepsis in lactoferrin or placebo-supplemented groups. Thus, lactoferrin cannot currently be considered an effective therapy to prevent late-onset sepsis