Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comment
. 2022 Nov;58(11):1958-1963.
doi: 10.1111/jpc.16128. Epub 2022 Jul 23.

Reducing antibiotic use in asymptomatic term infants exposed to maternal chorioamnionitis: Predictive role of sepsis risk calculator

Vanessa Dsouza  1 , Nakul Kothari  1 , Umesh Mishra  1 , Pranav Jani  1   2 , Rajesh Maheshwari  1   2 , Dharmesh Shah  1   2 , Daphne D'Cruz  1 , Jane Baird  1 , Melissa Luig  1
Affiliations
Comment

Reducing antibiotic use in asymptomatic term infants exposed to maternal chorioamnionitis: Predictive role of sepsis risk calculator

Vanessa Dsouza et al. J Paediatr Child Health. 2022 Nov.

Abstract

Aim: The sepsis risk calculator (SRC) has been shown to reduce empirical antibiotic usage in neonates at risk of early-onset sepsis without increasing adverse clinical outcomes. However, its use for categorising and improving identification of at-risk neonates exposed to chorioamnionitis in the local population has not been reported. This study compares the management guided by the SRC to our unit's clinical practice of administering empirical antibiotics to all term neonates (born ≥37 weeks gestation), symptomatic and asymptomatic, who were exposed to chorioamnionitis, and evaluates the performance of the SRC in managing asymptomatic term neonates exposed to chorioamnionitis.

Methods: This single-centre retrospective study identified 178 eligible term neonates exposed to chorioamnionitis over a 17-month study period. Relevant demographic and clinical information on the mother-infant dyad was collected. The SRC was executed retrospectively in the study cohort. Descriptive statistics were used for reporting the findings.

Results: The mean gestational age was 39 (standard deviation, SD 1) weeks, and the mean birth weight was 3472 (SD 482) g. Of the 178 neonates, 136 (76%) were asymptomatic and received empirical antibiotic therapy for 2 days (mean). Based on management recommendations from the SRC, empirical antibiotic therapy could have been avoided in 98% of asymptomatic neonates; 88% could have been managed by observation alone, avoiding mother-infant separation. No neonate died or had a positive blood culture result.

Conclusions: The SRC could reduce antibiotic exposure in asymptomatic neonates exposed to chorioamnionitis. It could assist clinicians to categorise risk in neonates exposed to chorioamnionitis.

Keywords: chorioamnionitis; early-onset sepsis; neonate; sepsis risk calculator.

PubMed Disclaimer

Comment on

References

    1. Tita AT, Andrews WW. Diagnosis and management of clinical chorioamnionitis. Clin. Perinatol. 2010; 37: 339-54.
    1. Newton ER. Chorioamnionitis and intraamniotic infection. Clin. Obstet. Gynecol. 1993; 36: 795-808.
    1. Shatrov JG, Birch SCM, Lam LT, Quinlivan JA, McIntyre S, Mendz GL. Chorioamnionitis and cerebral palsy: A meta-analysis. Obstet. Gynecol. 2010; 116: 387-92.
    1. Prevention of perinatal group B streptococcal disease: A public health perspective. Centers for Disease Control and Prevention. MMWR Morb. Mortal. Wkly. Rep. 1996; 45: 1-24.
    1. Verani JR, McGee L, Schrag SJ. Prevention of perinatal group B streptococcal disease-revised guidelines from CDC, 2010. MMWR Morb. Mortal. Wkly Rep. 2010; 59: 1-36.

Substances

LinkOut - more resources