Niek B Achten1, Frans B Plötz2, Claus Klingenberg3, Martin Stocker4, Robin Bokelaar5, Merijn Bijlsma6, Eric Giannoni7, Annemarie M C van Rossum8, William E Benitz9. 1. Department of Pediatrics, Tergooi Hospital, Blaricum, The Netherlands; Faculty of Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands; Department of Pediatrics, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands. Electronic address: n.achten@erasmusmc.nl. 2. Department of Pediatrics, Tergooi Hospital, Blaricum, The Netherlands; Faculty of Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands. 3. Department of Pediatrics and Adolescent Medicine, University Hospital of North Norway, Tromsø, Norway; Pediatric Research Group, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway. 4. Department of Pediatrics, Children's Hospital Lucerne, Lucerne, Switzerland. 5. Department of Pediatrics, Tergooi Hospital, Blaricum, The Netherlands. 6. Departments of Neurology and General Pediatrics, Amsterdam University Medical Center, Amsterdam, The Netherlands. 7. Department Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital, Lausanne, Switzerland. 8. Department of Pediatrics, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands. 9. Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA.
Abstract
OBJECTIVES: To provide a comprehensive assessment of case stratification by the Neonatal Early-Onset Sepsis (EOS) Calculator, a novel tool for reducing unnecessary antibiotic treatment. STUDY DESIGN: A systematic review with individual patient data meta-analysis was conducted, extending PROSPERO record CRD42018116188. Cochrane, PubMed/MEDLINE, EMBASE, Web of Science, Google Scholar, and major conference proceedings were searched from 2011 through May 1, 2020. Original data studies including culture-proven EOS case(s) with EOS Calculator application, independent from EOS Calculator development, and including representative birth cohorts were included. Relevant (individual patient) data were extracted from full-text and data queries. The main outcomes were the proportions of EOS cases assigned to risk categories by the EOS Calculator at initial assessment and within 12 hours. Evidence quality was assessed using Newcastle-Ottawa scale, Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies, and GRADE tools. RESULTS: Among 543 unique search results, 18 were included, totaling more than 459 000 newborns. Among 234 EOS cases, EOS Calculator application resulted in initial assignments to (strong consideration of) empiric antibiotic administration for 95 (40.6%; 95% CI, 34.2%-47.2%), more frequent vital signs for 36 (15.4%; 95% CI, 11.0%-20.7%), and routine care for 103 (44.0%; 95% CI, 37.6%-50.6%). By 12 hours of age, these proportions changed to 143 (61.1%; 95% CI, 54.5%-67.4%), 26 (11.1%; 95% CI, 7.4%-15.9%), and 65 (27.8%; 95% CI, 22.1%-34.0%) of 234 EOS cases, respectively. CONCLUSIONS: EOS Calculator application assigns frequent vital signs or routine care to a substantial proportion of EOS cases. Clinical vigilance remains essential for all newborns.
OBJECTIVES: To provide a comprehensive assessment of case stratification by the Neonatal Early-Onset Sepsis (EOS) Calculator, a novel tool for reducing unnecessary antibiotic treatment. STUDY DESIGN: A systematic review with individual patient data meta-analysis was conducted, extending PROSPERO record CRD42018116188. Cochrane, PubMed/MEDLINE, EMBASE, Web of Science, Google Scholar, and major conference proceedings were searched from 2011 through May 1, 2020. Original data studies including culture-proven EOS case(s) with EOS Calculator application, independent from EOS Calculator development, and including representative birth cohorts were included. Relevant (individual patient) data were extracted from full-text and data queries. The main outcomes were the proportions of EOS cases assigned to risk categories by the EOS Calculator at initial assessment and within 12 hours. Evidence quality was assessed using Newcastle-Ottawa scale, Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies, and GRADE tools. RESULTS: Among 543 unique search results, 18 were included, totaling more than 459 000 newborns. Among 234 EOS cases, EOS Calculator application resulted in initial assignments to (strong consideration of) empiric antibiotic administration for 95 (40.6%; 95% CI, 34.2%-47.2%), more frequent vital signs for 36 (15.4%; 95% CI, 11.0%-20.7%), and routine care for 103 (44.0%; 95% CI, 37.6%-50.6%). By 12 hours of age, these proportions changed to 143 (61.1%; 95% CI, 54.5%-67.4%), 26 (11.1%; 95% CI, 7.4%-15.9%), and 65 (27.8%; 95% CI, 22.1%-34.0%) of 234 EOS cases, respectively. CONCLUSIONS: EOS Calculator application assigns frequent vital signs or routine care to a substantial proportion of EOS cases. Clinical vigilance remains essential for all newborns.
Authors: Fleur M Keij; Niek B Achten; Gerdien A Tramper-Stranders; Karel Allegaert; Annemarie M C van Rossum; Irwin K M Reiss; René F Kornelisse Journal: Front Pediatr Date: 2021-04-01 Impact factor: 3.418
Authors: Francesco Cavigioli; Francesca Viaroli; Irene Daniele; Michela Paroli; Luigi Guglielmetti; Elena Esposito; Francesco Cerritelli; Gianvincenzo Zuccotti; Gianluca Lista Journal: Antibiotics (Basel) Date: 2022-08-11
Authors: Linde Snoek; Merel N van Kassel; Jurjen F Krommenhoek; Niek B Achten; Frans B Plötz; Nina M van Sorge; Matthijs C Brouwer; Diederik van de Beek; Merijn W Bijlsma Journal: EClinicalMedicine Date: 2022-01-10