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Updated: Jun 21, 2025

A Murine Model of Fetal Exposure to Maternal Inflammation to Study the Effects of Acute Chorioamnionitis on Newborn Intestinal Development
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Antibiotic Stewardship in Chorioamnionitis Exposed Neonates, A Quality Improvement Project.

Jacquelyn Em Grev1,2, Mallary Van Tol2, Brooke Welker2

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South Dakota Medicine : the Journal of the South Dakota State Medical Association
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Summary

Implementing an early onset sepsis (EOS) calculator in infants exposed to chorioamnionitis safely reduced antibiotic use and duration. This quality improvement initiative decreased antibiotic exposure without missing any cases of EOS.

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Area of Science:

  • Neonatal Medicine
  • Infectious Disease
  • Quality Improvement Science

Background:

  • Neonatal early onset sepsis (EOS) rates in term infants have declined.
  • The 2018 AAP guidelines permit risk assessment for empiric antibiotics in infants ≥35 weeks gestation, including those exposed to chorioamnionitis.

Purpose of the Study:

  • To implement an EOS calculator for infants exposed to chorioamnionitis.
  • To safely decrease antibiotic exposure in this neonatal population.

Main Methods:

  • A quality improvement project utilized multiple Plan-Do-Study-Act (PDSA) cycles.
  • Data collected included antibiotic usage, laboratory tests, length of stay, and safety metrics.

Main Results:

  • Antibiotic exposure decreased from 100% to 75% in chorioamnionitis-exposed neonates.
  • Average antibiotic duration reduced from 68 to 40 hours.
  • Prolonged antibiotic courses, lumbar punctures, length of stay, and laboratory tests were decreased; no culture-confirmed EOS cases were missed.

Conclusions:

  • Quality improvement initiatives effectively implement evidence-based tools.
  • These initiatives can safely and appropriately reduce antibiotic exposure in neonates.