Early onset sepsis calculator implementation is associated with reduced healthcare utilization and financial costs in late preterm and term newborns

Abstract

The neonatal early onset sepsis (EOS) calculator is a novel tool for antibiotic stewardship in newborns, associated with a reduction of empiric antibiotic treatment for suspected EOS. We studied if implementation of the EOS calculator results in less healthcare utilization and lower financial costs of suspected EOS. For this, we compared two single-year cohorts of hospitalizations within 3 days after birth in a Dutch nonacademic teaching hospital, before and after implementation of the EOS calculator. All admitted newborns born at or after 35 weeks of gestation were eligible for inclusion. We analyzed data from 881 newborns pre-implementation and 827 newborns post-implementation. We found significant reductions in EOS-related laboratory tests performed and antibiotic days, associated with implementation of the EOS calculator. Mean length of hospital stay was shorter, and EOS-related financial costs were lower after implementation among term, but not among preterm newborns.Conclusion: In addition to the well-known positive impact on antibiotic stewardship, implementation of the EOS calculator is also clearly associated with reductions in healthcare utilization related to suspected EOS in late preterm and term newborns and with a reduction in associated financial costs among those born term.What is Known: • The early-onset sepsis (EOS) calculator is a novel tool for antibiotic stewardship in newborns, associated with a reduction in empiric antibiotic treatment for suspected EOS. What is New:• In newborns at risk for EOS, EOS calculator implementation is associated with a significant reduction in laboratory investigations related to suspected EOS and significantly shorter stay in those born term. • EOS calculator implementation in term newborns is associated with a mean reduction of €207 in costs for EOS-related care per admitted newborn.

Neonatal early‐onset sepsis calculator recommended significantly less empiric antibiotic treatment than national guidelines

“…They also lack data on adherence in clinical practice and the impact on patient outcomes. In contrast, the EOS calculator has been associated with good adherence and significant reductions in empiric antibiotic treatment and EOS‐related healthcare use and costs 3,5 …”

Use of Early-Onset Sepsis Risk Calculator for Neonates ≥ 34 Weeks in a Large Tertiary Neonatal Centre, Saudi Arabia

“…Furthermore, a significant reduction in antibiotic therapy usage from 5% to 2.6% achieved with the EOS calculator usage in several studies [9,14,15]. Also, calculator usage has been associated with a significant reduction of health utilization and associated costs (15). The presented study is the first report from the Kingdom of Saudi Arabia on implementing the EOS calculator among newborns.…”

“…Implementing the EOS calculator for predicting neonatal sepsis and close clinical observation might decrease NICU admissions in healthy-appearing infants [12,13]. Furthermore, a significant reduction in antibiotic therapy usage from 5% to 2.6% achieved with the EOS calculator usage in several studies [9,14,15]. Also, calculator usage has been associated with a significant reduction of health utilization and associated costs (15).…”

Early onset sepsis risk calculator: Application in an outer metropolitan hospital

“…In addition to potential health and relationship benefits, the EOScalc has been shown to have healthcare cost benefits in developed countries. 24,25 Savings resulted from cost reductions in the management of sepsis and direct and indirect costs for long-term disability. 24,25 Given newborns suspected of EOS at this outer metropolitan hospital in Melbourne are admitted to SCN to undergo investigation and receive empiric antibiotic therapy, and that the EOScalc recommended fewer patients be investigated and treated for suspected EOS, it is reasonable to assume that there would be an economic benefit for the hospital and state government if the EOScalc was implemented as part of clinical practice.…”

“…Forty-three mother-newborn pairs (25 males, 18 females) had complete data available for the EOScalc(Figure 1), and we included them in the analysis. Most newborns(25) were delivered via caesarean; 18 were delivered via normal vaginal delivery. The mean gestational age of newborns was 38 weeks (range: 34 weeks 1 day-41 weeks 3 days) with 17 born prematurely (34 weeks-36 weeks 6 days).…”