Variation in Current Management of Term and Late-preterm Neonates at Risk for Early-onset Sepsis: An International Survey and Review of Guidelines.

Détails

ID Serval
serval:BIB_74DE9C99633E
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Variation in Current Management of Term and Late-preterm Neonates at Risk for Early-onset Sepsis: An International Survey and Review of Guidelines.
Périodique
The Pediatric infectious disease journal
Auteur(s)
van Herk W., el Helou S., Janota J., Hagmann C., Klingenberg C., Staub E., Giannoni E., Tissieres P., Schlapbach L.J., van Rossum A.M., Pilgrim S.B., Stocker M.
ISSN
1532-0987 (Electronic)
ISSN-L
0891-3668
Statut éditorial
Publié
Date de publication
05/2016
Peer-reviewed
Oui
Volume
35
Numéro
5
Pages
494-500
Langue
anglais
Notes
Publication types: Journal Article Publication Status: ppublish

Résumé
Uncertainty about the presence of infection results in unnecessary and prolonged empiric antibiotic treatment of newborns at risk for early-onset sepsis (EOS). This study evaluates the impact of this uncertainty on the diversity in management.
A web-based survey with questions addressing management of infection risk-adjusted scenarios was performed in Europe, North America, and Australia. Published national guidelines (n = 5) were reviewed and compared with the results of the survey.
439 Clinicians (68% were neonatologists) from 16 countries completed the survey. In the low-risk scenario, 29% would start antibiotic therapy and 26% would not, both groups without laboratory investigations; 45% would start if laboratory markers were abnormal. In the high-risk scenario, 99% would start antibiotic therapy. In the low-risk scenario, 89% would discontinue antibiotic therapy before 72 hours. In the high-risk scenario, 35% would discontinue therapy before 72 hours, 56% would continue therapy for 5-7 days, and 9% for more than 7 days. Laboratory investigations were used in 31% of scenarios for the decision to start, and in 72% for the decision to discontinue antibiotic treatment. National guidelines differ considerably regarding the decision to start in low-risk and regarding the decision to continue therapy in higher risk situations.
There is a broad diversity of clinical practice in management of EOS and a lack of agreement between current guidelines. The results of the survey reflect the diversity of national guidelines. Prospective studies regarding management of neonates at risk of EOS with safety endpoints are needed.

Mots-clé
Australia, Case Management, Europe, Guideline Adherence, Guidelines as Topic, Health Policy, Humans, Infant, Newborn, Neonatal Sepsis/diagnosis, Neonatal Sepsis/therapy, North America, Surveys and Questionnaires
Pubmed
Création de la notice
12/02/2016 10:00
Dernière modification de la notice
03/03/2018 18:22
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