Garber et al reported criteria for identifying a neonate at low risk for early-onset infection. These patients can be managed without empiric antibiotic therapy. The authors are from Children's Hospital Philadelphia and University of Pennsylvania.
Patient selection: pre-term neonate, very low (< 1,500 g) or extremely low (< 1,000g) birth weight
Goal of empiric therapy: prevent early-onset sepsis
Criteria for early-onset sepsis: growth of pathogen from blood or CSF culture obtained within 72 hours of birth
Criteria for low-risk neonate:
(1) delivery by Cesarean section AND no labor AND no membrane rupture
(2) well-appearing AND no need for hemodynamic support AND no need for respiratory support
Exclusions:
(1) placental abruption
(2) attempts to induce labor
(3) unexplained isolated fetal distress
A low-risk neonate can be managed initially without empiric antibiotic therapy.
To read more or access our algorithms and calculators, please log in or register.
