Early-Onset Sepsis Online Calculator as a Predictor of Early-Onset Sepsis in Neonates Born at ≥ 34 Weeks of Gestation

Fitriani Ikhsaniatun, Dwi Hidayah, Annang Giri Moelyo

Abstract

Background: Early-onset sepsis (EOS) in neonates is a global health concern that results in the high use of antibiotics in neonates. The EOS calculator is an online tool developed to predict the EOS incidence and avoid unnecessary use of antibiotics in neonates.

Aim: To calculate the predictive value of the online EOS calculator in identifying the EOS incidence in neonates born at ≥ 34 weeks of gestation

Materials and Methods: This prospective cohort study was conducted in neonates born at ≥ 34 weeks of gestation, diagnosed with sepsis based on the WHO clinical sepsis criteria, and admitted in neonatal HCU or NICU of Dr Moewardi Hospital (Surakarta, Central Java, Indonesia) from May 2019 to December 2019. Sepsis criteria were assessed using the EOS calculator and the WHO clinical sepsis criteria.

Results: In this study, 82 neonates were included, of which 52 (63.4%) were at a risk of developing EOS according to the EOS calculator. Blood cultures were positive in 21 (25.6%) neonates. The use of antibiotics decreased by 36.6% by following the EOS calculator’s recommendation. The WHO sepsis criteria and the EOS calculator can be used to predict EOS (proven EOS) (RR, 2.53; 95% CI: 1.18–5.43; P = .013, and RR, 3.46; 95% CI: 1.11–10.78; P = .014, respectively).

Conclusion: The EOS calculator can help predict EOS incidence and reduce unnecessary antibiotic use in neonates.