@article{097c82dd94f347d9b26cba38343b4429,
title = "Early onset sepsis calculator implementation is associated with reduced healthcare utilization and financial costs in late preterm and term newborns",
abstract = "The neonatal early onset sepsis (EOS) calculator is a novel tool for antibiotic stewardship in newborns, associated with a reduction of empiric antibiotic treatment for suspected EOS. We studied if implementation of the EOS calculator results in less healthcare utilization and lower financial costs of suspected EOS. For this, we compared two single-year cohorts of hospitalizations within 3 days after birth in a Dutch nonacademic teaching hospital, before and after implementation of the EOS calculator. All admitted newborns born at or after 35 weeks of gestation were eligible for inclusion. We analyzed data from 881 newborns pre-implementation and 827 newborns post-implementation. We found significant reductions in EOS-related laboratory tests performed and antibiotic days, associated with implementation of the EOS calculator. Mean length of hospital stay was shorter, and EOS-related financial costs were lower after implementation among term, but not among preterm newborns. Conclusion: In addition to the well-known positive impact on antibiotic stewardship, implementation of the EOS calculator is also clearly associated with reductions in healthcare utilization related to suspected EOS in late preterm and term newborns and with a reduction in associated financial costs among those born term",
keywords = "Costs, EOS calculator, Early-onset sepsis, Healthcare utilization, Newborn, MANAGEMENT, RISK",
author = "N.B. Achten and D.H. Visser and E. Tromp and W. Groot and {van Goudoever}, J.B. and F.B. Pl{\"o}tz",
note = "Correspondence Address: Achten, N.B.; Department of Pediatrics, Tergooi Hospitals, Rijksstraatweg 1, 1261 AN, Netherlands; email: niek.achten@gmail.com References: Escobar, G.J., Puopolo, K.M., Wi, S., Turk, B.J., Kuzniewicz, M.W., Walsh, E.M., Newman, T.B., Draper, D., Stratification of risk of early-onset sepsis in newborns ≥34 weeks{\textquoteright} gestation (2014) Pediatrics, 133, pp. 30-36; Kuzniewicz, M.W., Puopolo, K.M., Fischer, A., Walsh, E.M., Li, S., Newman, T.B., Kipnis, P., Escobar, G.J., A quantitative, risk-based approach to the management of neonatal early-onset sepsis (2017) JAMA Pediatr, 171, pp. 365-371; Achten, N.B., Dorigo-Zetsma, J.W., van der Linden, P.D., van Brakel, M., Pl{\"o}tz, F.B., Sepsis calculator implementation reduces empiric antibiotics for suspected early-onset sepsis (2018) Eur J Pediatr, 177, pp. 741-746; Achten, N.B., Klingenberg, C., Benitz, W.E., Stocker, M., Schlapbach, L.J., Giannoni, E., Bokelaar, R., Pl{\"o}tz, F.B., Association of use of the neonatal early-onset sepsis calculator with reduction in antibiotic therapy and safety: a systematic review and meta-analysis (2019) JAMA Pediatr, 173, p. 1032; Beavers, J.B., Bai, S., Perry, J., Implementation and evaluation of the early-onset sepsis risk calculator in a high-risk university nursery (2018) Clin Pediatr (Phila), 57, pp. 1080-1085; Gievers, L.L., Sedler, J., Phillipi, C.A., Dukhovny, D., Geddes, J., Graven, P., Chan, B., Khaki, S., Implementation of the sepsis risk score for chorioamnionitis-exposed newborns (2018) J Perinatol, 38, pp. 1-1587; Gong, C.L., Dasgupta-Tsinikas, S., Zangwill, K.M., Bolaris, M., Hay, J.W., Early onset sepsis calculator-based management of newborns exposed to maternal intrapartum fever: a cost benefit analysis (2019) J Perinatol, 39, pp. 571-580; Ayrapetyan, M., Carola, D., Lakshminrusimha, S., Bhandari, V., Aghai, Z., Infants Born to Mothers with Clinical Chorioamnionitis: A Cross-Sectional Survey on the Use of Early-Onset Sepsis Risk Calculator and Prolonged Use of Antibiotics (2018) American Journal of Perinatology, 36 (4), pp. 428-433; Dhudasia, M.B., Mukhopadhyay, S., Puopolo, K.M., Implementation of the sepsis risk calculator at an academic birth hospital (2018) Hosp Pediatr, 8, pp. 243-250; Strunk, T., Buchiboyina, A., Sharp, M., Nathan, E., Doherty, D., Patole, S., Implementation of the neonatal sepsis calculator in an Australian tertiary perinatal centre (2018) Neonatology, 113, pp. 379-382; Levels of neonatal care (2012) Pediatrics, 130, pp. 587-597; Skovlund, E., Fenstad, G.U., Should we always choose a nonparametric test when comparing two apparently nonnormal distributions? (2001) J Clin Epidemiol, 54, pp. 86-92. , COI: 1:STN:280:DC%2BD3M7lsFaksQ%3D%3D; Fagerland, M.W., Sandvik, L., Performance of five two-sample location tests for skewed distributions with unequal variances (2009) Contemp Clin Trials, 30, pp. 490-496; Fagerland, M.W., T-tests, non-parametric tests, and large studies––a paradox of statistical practice? (2012) BMC Med Res Methodol, 12, p. 78; Mukherjee, A., Davidson, L., Anguvaa, L., Duffy, D.A., Kennea, N., NICE neonatal early onset sepsis guidance: greater consistency, but more investigations, and greater length of stay (2015) Arch Dis Child Fetal Neonatal Ed, 100, pp. F248-F249; Papanicolas, I., Woskie, L.R., Jha, A.K., Health care spending in the United States and other high-income countries (2018) JAMA - J Am Med Assoc, 319, pp. 1024-1039; Neonatal infection (Early onset): Antibiotics for prevention and treatment (2012) Clin. Guidel, , https://www.nice.org.uk/guidance/cg149/resources/neonatal-infection-early-onset-antibiotics-for-prevention-and-treatment-35109579233221, Accessed 19 Jun 2018; (2017) Preventie en behandeling van early-onset neonatale infecties (Adaptatie van de NICE-richtlijn), pp. 1-94; van Herk, W., el Helou, S., Janota, J., Hagmann, C., Klingenberg, C., Staub, E., Giannoni, E., Stocker, M., Variation in current management of term and late-preterm neonates at risk for early-onset sepsis: an international survey and review of guidelines (2016) Pediatr Infect Dis J, 35, pp. 494-500",
year = "2020",
month = may,
doi = "10.1007/s00431-019-03510-9",
language = "English",
volume = "179",
pages = "727--734",
journal = "European Journal of Pediatrics",
issn = "0340-6199",
publisher = "Springer, Cham",
number = "5",
}