Impact of neonatal sepsis calculator in West Midlands (UK)

Tim J van Hasselt, Helen McDermott, Pinki Surana, Rawia Eltahir, Laura Macaskill, Raunak Jain, Nicola McMullan, Samantha Slee, Megha Jagga, Muhammed Naseem, Oluwaseyi Alake, Canada Cherry, Benjamin Miguras, Andrew Ewer

Research output: Contribution to journalLetterpeer-review

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Abstract

The Kaiser Permanente Sepsis Risk Calculator (KP-SRC) was developed to predict early-onset neonatal sepsis (EOS), using continuous variables (local EOS incidence rates, maternal factors, infant well-being) to guide decision making.1

KP-SRC has been adopted in Plymouth and Wales, reducing antibiotic use by up to 84%2 3 compared with using National Institute for Health and Care Excellence (NICE) guidelines. This may reduce antibiotic resistance, dysbiosis,2 invasive procedures and mother–baby separation, although some safety concerns have been raised.4

We performed a virtual application of the KP-SRC versus NICE guidance on postnatal antibiotic usage and length of stay, using anonymised clinical data collected prospectively across 11 neonatal units in the West Midlands, UK. The Health Research Authority confirmed ethical approval was not required.

All infants born ≥34 weeks’ gestation between 1 January 2020 and 29 February 2020 who were commenced on antibiotics for EOS and managed as per NICE guidelines were included. Those admitted to the neonatal unit prior to commencing antibiotics were excluded.

The KP-SRC was applied retrospectively, using two EOS incidence rates—1/1000 and 2/1000 live births (West Midlands rate varies between 0.7 and 1.3/1000). KP-SRC recommendations were analysed against evidence of EOS.

Data from 626 infants were collected and 599 were included for analysis (figure 1).
Original languageEnglish
JournalArchives of disease in childhood. Fetal and neonatal edition
Early online date8 Dec 2020
DOIs
Publication statusE-pub ahead of print - 8 Dec 2020

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