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Revised algorithm decreased costs, number of early-onset sepsis evaluations
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Recent study findings show that a revised local algorithm for neonatal early-onset sepsis decreased the number of newborn evaluations without short-term harm, thereby reducing resource expenditures.
The study consisted of two trial periods. The first trial occurred from 2009 to 2010 and used an algorithm based on 2002 CDC guidelines; and the second trial was conducted from 2011 to 2012 using a revised algorithm based on 2010 CDC guidelines. The first trial period included 920 neonates, and the second trial included 476 neonates. All study participants were born at Brigham and Women’s Hospital in Boston.
Researchers found early-onset sepsis evaluations decreased from 126 per 1,000 live births to 68 per 1,000 live births. The frequency of early-onset sepsis evaluation among infants who received group B streptococcus prophylaxis in utero decreased from 32 per 1,000 live births to fewer than one per 1,000 live births. Costs associated with evaluations decreased by $6,994 per 1,000 live births, and work hours associated with early-onset sepsis evaluations decreased by 29 per 1,000 live births.
“A local algorithm for neonatal [early-onset sepsis] evaluation based on the CDC 2010 guidelines resulted in a significant decrease in evaluation of well-appearing infants and demonstrable cost savings, without apparent harmful consequences. Even with a more restrictive algorithm, a significant proportion of uninfected, asymptomatic term infants were treated with systemic broad-spectrum antibiotics, highlighting the need for more effective diagnostic tests and/or predictive models for neonatal [early-onset sepsis],” study researcher Sagori Mukhopadhyay, MD, MMSc, of the Boston Children’s Hospital, and colleagues concluded.
Disclosure: The researchers report no relevant financial disclosures.
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