Good Pamela I, Hooven Thomas A
Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, PH-17, New York, NY 10032, USA.
Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, PH-17, New York, NY 10032, USA.
Pediatr Clin North Am. 2019 Apr;66(2):321-331. doi: 10.1016/j.pcl.2018.12.003. Epub 2019 Feb 1.
Early-onset sepsis (EOS) is an important cause of neonatal morbidity. Despite extensive study, identifying at-risk newborns remains challenging, especially if they are initially well appearing. Existing official EOS recommendations suggest a conservative approach that likely results in overtreatment of a low-risk population. Recent studies indicate that more precise risk assessment and alternative management strategies could decrease the number of infants exposed to blood draws and antibiotics during evaluations for EOS. This article reviews existing guidelines and provides an overview of the Bayesian sepsis calculator and serial observation as an alternative to laboratory studies and empirical antibiotics.
早发型败血症（EOS）是新生儿发病的一个重要原因。尽管进行了广泛研究，但识别高危新生儿仍然具有挑战性，尤其是那些最初外观正常的新生儿。现有的官方EOS建议提出了一种保守方法，这可能导致对低风险人群的过度治疗。最近的研究表明，更精确的风险评估和替代管理策略可以减少在EOS评估期间接受采血和抗生素治疗的婴儿数量。本文回顾了现有指南，并概述了贝叶斯败血症计算器和连续观察，作为实验室检查和经验性抗生素治疗的替代方法。
