Recommendations of Polin et al for Managing an Asymptomatic Infant >= 37 Weeks of Gestation with Risk Factors for Sepsis Other Than Chorioamnionitis

Description

The American Academy of Pediatrics (AAP) issues guidance for managing an asymptomatic infant >= 37 weeks of gestation born with risk factors other than maternal chorioamnionitis. The goal is to provide or discontinue antibiotic therapy based on need.

Parameters: asymptomatic neonate >= 37 weeks of gestation AND other risk factors for sepsis (premature rupture of membranes >= 18 hours, inadequate intra-partum antibiotic prophylaxis)

Initial management:

(1) A WBC with differential and CRP are collected 6-12 hours after birth.

(2) No antibiotics are given.

(3) The neonate is observed for clinical signs of sepsis.

(4) Blood cultures are drawn if laboratory data indicates sepsis or if the patient becomes symptomatic.

Lab Data	Clinical Status	Blood Cultures	Management
normal	normal	NA	Discharge by 48 hours.
abnormal	normal	negative	Discharge by 48 hours.
abnormal	NA	positive	Manage for sepsis.
NA	abnormal	positive	Manage for sepsis
other	other	negative	Monitor and manage accordingly.

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Description

Specialty

ICD-10