Reduction in the use of diagnostic tests in infants with risk factors for early-onset neonatal sepsis does not delay antibiotic treatment

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Ressource 1Télécharger: BIB_B1AA67B6BC40.P001.pdf (635.77 [Ko])
Etat: Serval
Version: Après imprimatur
ID Serval
serval:BIB_B1AA67B6BC40
Type
Thèse: thèse de doctorat.
Collection
Publications
Titre
Reduction in the use of diagnostic tests in infants with risk factors for early-onset neonatal sepsis does not delay antibiotic treatment
Auteur(s)
Duvoisin G.
Directeur(s)
Giannoni E.
Institution
Université de Lausanne, Faculté de biologie et médecine
Adresse
Faculté de biologie et de médecine Université de Lausanne CH-1015 Lausanne SUISSE
Statut éditorial
Acceptée
Date de publication
2014
Langue
anglais
Nombre de pages
6
Résumé
BACKGROUND: Despite a low positive predictive value, diagnostic tests such as complete blood count (CBC) and C-reactive protein (CRP) are commonly used to evaluate whether infants with risk factors for early-onset neonatal sepsis (EOS) should be treated with antibiotics.
STUDY
DESIGN: We investigated the impact of imple- menting a protocol aiming at reducing the number of dia- gnostic tests in infants with risk factors for EOS in order to compare the diagnostic performance of repeated clinical examination with CBC and CRP measurement. The primary outcome was the time between birth and the first dose of antibiotics in infants treated for suspected EOS.
RESULTS: Among the 11,503 infants born at 35 weeks during the study period, 222 were treated with antibiotics for suspected EOS. The proportion of infants receiving an- tibiotics for suspected EOS was 2.1% and 1.7% before and after the change of protocol (p = 0.09). Reduction of dia- gnostic tests was associated with earlier antibiotic treat- ment in infants treated for suspected EOS (hazard ratio 1.58; 95% confidence interval [CI] 1.20-2.07; p <0.001), and in infants with neonatal infection (hazard ratio 2.20; 95% CI 1.19-4.06; p = 0.01). There was no difference in the duration of hospital stay nor in the proportion of infants requiring respiratory or cardiovascular support before and after the change of protocol.
CONCLUSION: Reduction of diagnostic tests such as CBC and CRP does not delay initiation of antibiotic treat- ment in infants with suspected EOS. The importance of clinical examination in infants with risk factors for EOS should be emphasised.
Mots-clé
bacterial infection, newborn infant, Group B Streptococcus, C-reactive protein, complete blood count
Création de la notice
14/04/2016 9:26
Dernière modification de la notice
03/03/2018 20:36
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