User:JedBarlet/Neonatal sepsis

Antibiotic Overtreatment
In cases of suspected Early Onset Sepsis (EOS) one of the treatments is empirical antibiotics. The strategy of clinicians utilizing antibiotics as a course of treatment for EOS has resulted in the overtreatment of antibiotics to infants suspected of having signs of EOS. There are several consequences to the overtreatment of antibiotics in newborns including "microbiome alterations, which are linked to the development of asthma, food allergies, and childhood obesity". Another risk in the early introduction of antibiotics in infants is the increase in the development of antibiotic-resistant strains of infectious disease. Current methods of treatment for EOS are often implemented before a positive sepsis blood culture is found. In the last two decades (2000-2020), the use of intrapartum antibiotics has reduced the incidence of EOS. The current challenge faced by clinicians is mainly weighing the risk and benefits of the possibility of antibiotic overtreatment vs. the effects of sepsis.

Neonatal Early-Onset Sepsis Calculator
From 1993 to 2007, doctors at Kaiser Permanente Medical Care Program hospitals, Brigham Women's Hospital, and Beth Israel-Deaconess Medical Center conducted a nested case-control study in an effort to create a better quantitative method for determining risk factors for neonatal early-onset sepsis. The study examined over 600,000 live births of infants born less than or equal to 34 weeks gestation. The study used measures of health available at the time of birth such as highest intrapartum maternal temperature, rupture of membranes, whether or not the mother has group b streptococcus, and if the mother was given any intrapartum antibiotics. Intrapartum prophylaxis is a strategy for "the secondary prevention of early-onset GBS disease in newborns" that could lead to EOS. The Sepsis Risk Calculator (SRS) is meant to be another clinical measure that physicians can use in conjunction with physical examination.

An evaluation of the SRS was done in an independent retrospective cohort study by doctors at a University Hospital in Greece. The study aimed to "compare our clinical practice based on risk-factor guidance with that projected through the application of the SRC". The study incorporated 2,084 infants and found that "The adoption of SRC would have significantly reduced antibiotic usage; however, a significant portion of cases with clinical EOS would have been missed". Another study evaluated the impact of Integrating the SRC into the electronic health record in order to "improve compliance and accuracy through automation". The study concluded that the integration of the EOS into the electronic health record system "significantly increased calculator accuracy".