title: Application of sepsis calculator in newborns with suspected infection.
abstract: OBJECTIVE
  To compare actual antibiotic use to the stratification based on the sepsis calculator in newborns with suspected early onset sepsis (EOS). To investigate differences in EOS risk and vital signs between newborns that received early (<12 h) versus late antibiotics (≥12 h of life).
  
  
  METHODS
  Newborns born ≥34 weeks gestation in 2014 treated with antibiotics started within 72 h after birth were included. We calculated the risk per 1000 live births and retrospectively assigned each newborn to one of four recommended categories using the sepsis calculator.
  
  
  RESULTS
  There were 2094 newborns, 111 (5.3%) received antibiotics and 108 newborns were included. The incidence of culture-proven EOS was 0.096%. In 57 newborns, the advice of the sepsis calculator was not to start antibiotic therapy. Antibiotic treatment was started early in 66 (61%) and late in 42 (39%) newborns. In the "late treatment" group, clinical condition deteriorated, including two newborns with culture-proven EOS. Tachypnea and respiratory distress were significantly more present.
  
  
  CONCLUSIONS
  Antibiotic use could be reduced by more than 50%. Newborns with initial low sepsis risk score clinically deteriorated beyond 12 h of life. Continuous good clinical observation remains very important. Prospective validation is necessary to evaluate the safety of this approach.
authors.affiliation: a Department of Pediatrics .
authors.forename: Marleen
authors.initials: M
authors.lastname: Kerste
authors.affiliation: a Department of Pediatrics .
authors.forename: Jellina
authors.initials: J
authors.lastname: Corver
authors.affiliation: a Department of Pediatrics .
authors.forename: Martine C
authors.initials: MC
authors.lastname: Sonnevelt
authors.affiliation: a Department of Pediatrics .
authors.forename: Monique
authors.initials: M
authors.lastname: van Brakel
authors.affiliation: b Department of Clinical Pharmacology , and.
authors.forename: Paul D
authors.initials: PD
authors.lastname: van der Linden
authors.affiliation: c Department of Obstetrics and Gynecology , Tergooi Hospital , Blaricum , The Netherlands.
authors.forename: Babette A
authors.initials: BA
authors.lastname: M Braams-Lisman
authors.affiliation: a Department of Pediatrics .
authors.forename: Frans B
authors.initials: FB
authors.lastname: Plötz
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001831:Body Temperature; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D015997:Neonatal Screening / Q000379:methods*; D000071074:Neonatal Sepsis / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D018709:Statistics, Nonparametric; D061665:Time-to-Treatment
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotics; early onset sepsis; infection; newborns; sepsis calculator