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Effect of Serial Clinical Observation Complemented by Point-of-Care Blood Culture Volume Verification on Antibiotic
Tomasz Wawrzoniak1, Justyna Romańska1
1Medical University of Warsaw, Warsaw, Poland.
Insights
A new strategy using clinical observation and blood culture checks significantly reduced antibiotic use in newborns at risk for early-onset sepsis. This approach lowered antibiotic exposure from 4.1% to 0.6% in at-risk infants.
Area of Science:
- Neonatal Medicine
- Pediatric Infectious Diseases
- Clinical Practice Guidelines
Background:
- Early-onset sepsis poses a significant risk to term and near-term newborns.
- Overuse of antibiotics in neonates can lead to adverse outcomes, including antimicrobial resistance.
- Accurate assessment of blood culture volume is crucial for reliable sepsis diagnosis.
Purpose of the Study:
- To evaluate the impact of a serial clinical observation strategy combined with point-of-care blood culture volume verification.
- To assess the effect of this strategy on antibiotic utilization in newborns at risk for early-onset sepsis.
Main Methods:
- A before-and-after study design was employed.
- Infants born at or after 35 0/7 weeks' gestation were included.
- The strategy involved serial clinical observation and point-of-care verification of blood culture volume.
Main Results:
- Antibiotic therapy initiation within the first 3 days of life decreased significantly post-intervention (0.6% vs. 4.1%).
- The relative risk of antibiotic exposure was substantially reduced (RR: 0.15; 95% CI: 0.08-0.28).
- The observed reduction in antibiotic use was statistically significant (P < .001).
Conclusions:
- Serial clinical observation and blood culture volume verification can effectively reduce unnecessary antibiotic use in newborns.
- This strategy offers a promising approach to managing neonatal sepsis risk while minimizing antibiotic exposure.
- Optimizing sepsis management protocols can improve neonatal outcomes and combat antimicrobial resistance.
Abstract:
Objective. This study evaluated the effects of serial clinical observation strategy complemented by point-of-care verification of blood culture volume in managing term and near-term newborns at risk for early-onset sepsis. Methods. We used a "before-and-after" approach. Infants born at ≥35 0/7 weeks' gestation were eligible. Our strategy was based on serial clinical observation complemented with point-of-care verification of blood culture volume. Two separate 12-month periods were analyzed. The number of infants exposed to antibiotics started during the first 3 days of life was compared before and after introducing the strategy. Results. During the post-intervention period, 0.6% of infants received antibiotic therapy, compared to 4.1% during the pre-intervention period (P < .001; relative risk [RR]: 0.15; 95% CI: 0.08-0.28). Conclusion. Serial clinical observation complemented with verification of blood culture volume might reduce antibiotic utilization in newborns in the early postnatal period.
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