Implementing a Comprehensive Risk Assessment for Early Onset Sepsis to Reduce Antibiotic Usage in the NICU

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Recent research and a change in guidance from the American Academy of Pediatrics (AAP) regarding the management of early onset sepsis shows that the historical practice of empiric antibiotic administration to well-appearing newborn infants exposed to chorioamnionitis is uneccesary and may be harmful to their future health. This project aimed to standardize the risk assessment and management of these infants born at greater than or equal to 35 weeks gestation at Thomas Jefferson University Hospital (TJUH) in order to decrease their exposure to antibiotics. Using healthcare quality improvement methodology, a new assessment and management guideline based upon local clinical research and guidance from the AAP was developed and implemented at TJUH. Following initiation of the project, empiric antibiotic adminsitration in this cohort of neonates decreased from 100% to 34% with no evidence of missed or undertreated cases of early onset sepsis. Antibiotic usage in the NICU can be significantly and safely reduced by implementing an evidence-based comprehensive risk assessment and management guideline similar to the one developed for this project.



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