[Pediatric management of early-onset neonatal sepsis: guidelines adherence in Lille's perinatal care network]

Abstract

Neonatal early-onset infection has been recognized as a significant cause of perinatal mortality and morbidity, in spite of recent improvement in perinatal care. In France, Anaes guidelines were published in 2002.

Objectives: To evaluate paediatricians' knowledge about these official guidelines in Lille's perinatal network.

Materials and methods: Every network's paediatrician, working in a hospital maternity or in a neonatology unit received a questionnaire, to evaluate his knowledge about early onset sepsis diagnosis, indication and type of per partum antibiotherapy, and immediate neonatal care, according to perinatal factors.

Results: Response rate was 55%. Thirty-five per cent of paediatricians underestimated gastric sample's diagnostic role and 41% prescribed a triple antibiotherapy. Duration of antibiotic treatment was too long in 56% of cases. Biologic tests were prescribed in excess in 71% of cases when a streptoccocal B mother's colonization was present. Per partum antibiotherapy was appropriated in only 29% of responses.

Conclusion: This study underlines imperfect official guidelines' knowledge, leading to ecological, bacterial, and economical consequences.