Use of an Early Onset-Sepsis Calculator to Decrease Unnecessary NICU Admissions and Increase Exclusive Breastfeeding

Agreement between an Early-Onset Neonatal Sepsis Risk Calculator and the Colombian Clinical Practice Guideline in Three Tertiary-Care Centers in Bogotá, Colombia

“…Risk assessment calculators should simply be an additional tool to be used in clinical practice (1). A potential reduction in unnecessary antibiotic use could mitigate the effects of alterations in the intestinal microbiota, such as the development of chronic illnesses [8][9][10][11][12][13][14][15][16][17][18][20][21][22]34 . This potential benefit justifies further prospective and controlled studies that can explore the effects of EOSCalc's use on these outcomes.…”

“…Both the United Kingdom's NICE guideline and the Colombian Early-Onset Neonatal Sepsis Clinical Practice Guidelines (CPG) discourage the use of risk assessment tools in managing EONS 5,6 . However, various studies have been carried out to evaluate the clinical, economic and social outcomes derived from using EOSCalc in different populations, with favorable results like reductions in the rates of NICU admissions, procedures and antibiotic use 1,[7][8][9][10][11][12][13][14][15][16][17][18][19] . Other studies highlight the concern that EOSCalc may miss EONS cases, leading to delays in diagnosis and negative outcomes 1,[19][20][21][22][23] .…”

Cost savings from use of a neonatal sepsis calculator in Australia: A modelled economic analysis

“…1,8,15,16 Secondary outcomes have included reduction in BC collection, testing of other blood markers of infection and admissions to the neonatal nursery, and increased exclusive breastfeeding rates. 1,8,15,16,18 A recent study showed the EOS calculator to have better predictive value of EOS than measurement of full blood count and C-reactive protein, although procalcitonin levels had marginally better predictive value than the EOS calculator. 19 There may also be financial cost reductions associated with use of the EOS calculator.…”

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

“…Management of suspected EOS, whether proven by blood culture or not, impacts on both newborns and their parents. Investigation procedures are painful, 17 and treating suspected EOS means newborns are separated from their mothers, which is linked with late initiation of breastfeeding and increased formula supplementation. 18 Furthermore, neonatal antibiotic administration may influence the composition of the infant gut microbiome, predisposing it to necrotising enterocolitis in the extremely premature population.…”

“…20 Studies conducted in developed countries worldwide suggest that the EOScalc tool is both safe and effective, with implementation associated with numerous positive outcomes without increasing mortality. 3,[5][6][7]10,17,[21][22][23] These outcomes include a reduction in empiric antibiotic therapy use in the first 24 hours from 5.0% to 2.6% (adjusted difference, −1.8%; 95% CI, −2.4% to −1.3%) following implementation of the EOScalc, 5,610,23 fewer laboratory tests (reduced from 14.5% to 4.9%; adjusted difference, -7.7%; 95% CI, -13.1% to -2.4%), 7 and fewer admissions to SCN and NICU (93% reduction from baseline). 17 Furthermore, the EOScalc reduces the number of newborns separated from their family, increases exclusive breastfeeding rates (from less than 10% to over 50%) 17 and improves maternal-newborn bonding.…”