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新生儿早发型败血症计算器对两个三级医疗中心抗生素使用的影响。

Impact of neonatal early-onset sepsis calculator on antibiotic use within two tertiary healthcare centers.

作者信息

Warren S, Garcia M, Hankins C

机构信息

Providence St. Vincent Medical Center, Portland, OR, USA.

Providence Portland Medical Center, Portland, OR, USA.

出版信息

J Perinatol. 2017 Apr;37(4):394-397. doi: 10.1038/jp.2016.236. Epub 2016 Dec 22.

Abstract

OBJECTIVE

A recently described neonatal early-onset sepsis (EOS) calculator has the potential to reduce newborn antibiotic exposure but real world data from its use remains sparse. The objective of this study was to determine the impact of applying the calculator to infants treated for EOS.

STUDY DESIGN

Retrospective review of infants ⩾34 weeks gestational age who received antibiotics at birth. Subjects were compared according to Centers for Disease Control (CDC) 2010 guideline criteria versus the Kaiser Permanente neonatal EOS calculator recommendations.

RESULTS

Of 205 patients, the EOS calculator recommended empiric antibiotics for 23% of those who received therapy, compared with 92% per CDC guidelines (P<0.001). No cases of culture-positive sepsis were identified.

CONCLUSION

Use of the neonatal EOS calculator may dramatically reduce the number of infants who require antibiotics at birth, leading to reduced need for laboratory monitoring and improved antimicrobial stewardship. More safety data is needed.

摘要

目的

最近描述的一种新生儿早发型败血症(EOS)计算器有潜力减少新生儿抗生素暴露,但关于其实际应用的数据仍然稀少。本研究的目的是确定将该计算器应用于接受EOS治疗的婴儿的影响。

研究设计

对胎龄≥34周且出生时接受抗生素治疗的婴儿进行回顾性研究。根据疾病控制中心(CDC)2010年指南标准与凯撒医疗集团新生儿EOS计算器的建议对受试者进行比较。

结果

在205例患者中,EOS计算器建议对23%接受治疗的患者使用经验性抗生素,而根据CDC指南这一比例为92%(P<0.001)。未发现培养阳性败血症病例。

结论

使用新生儿EOS计算器可能会显著减少出生时需要使用抗生素的婴儿数量,从而减少实验室监测的需求并改善抗菌药物管理。还需要更多的安全性数据。

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