Decision Tree of Metsvaht et al for Predicting Failure of Empirical Antibiotic Therapy in Early Onset Neonatal Sepsis Based on Data Available at 72 Hours After Birth

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Mesvaht et al analyzed factors associated with failure of empirical antibiotic therapy in a neonate with early onset sepsis. They developed a decision tree for factors known at 72 hours after birth. The authors are from Tartu University and Tallinn Children's Hospital in Estonia.

Empirical antibiotic therapy: penicillin/ampicillin plus gentamicin

Parameters known at 72 hours after birth:

(1) blood glucose in mmol/L

(2) need for vasoactive treatment

(4) maximum white blood cell count in 10^9/L

(5) minimum white blood cell count in 10^9/L

(6) minimum platelet count in 10^9/L

Minimum Platelet	Vasoactive Therapy	Minimum WBC	Maximum WBC	Glucose	prob failure
< 94.5	yes	NA	NA	NA	0.70
< 94.5	no	NA	NA	NA	0.09
>= 94.5	NA	< 3.5	NA	NA	0.40
>= 94.5	NA	>= 3.5	>= 39.75	NA	0.30
>= 94.5	NA	>= 3.5	< 39.75	>= 1.65	0.27
>= 94.5	NA	>= 3.5	< 39.75	< 1.65	0.02

where:

• A glucose of 1.65 mmol/L is around 30 mg/dL.

A probability of treatment failure >= 0.27 was defined as treatment failure.

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Decision Tree of Metsvaht et al for Predicting Failure of Empirical Antibiotic Therapy in Early Onset Neonatal Sepsis Based on Data Available at 72 Hours After Birth

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