Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Impact of neonatal early-onset sepsis calculator on antibiotic use within two tertiary healthcare centers



A recently described neonatal early-onset sepsis (EOS) calculator has the potential to reduce newborn antibiotic exposure but real world data from its use remains sparse. The objective of this study was to determine the impact of applying the calculator to infants treated for EOS.

Study Design:

Retrospective review of infants 34 weeks gestational age who received antibiotics at birth. Subjects were compared according to Centers for Disease Control (CDC) 2010 guideline criteria versus the Kaiser Permanente neonatal EOS calculator recommendations.


Of 205 patients, the EOS calculator recommended empiric antibiotics for 23% of those who received therapy, compared with 92% per CDC guidelines (P<0.001). No cases of culture-positive sepsis were identified.


Use of the neonatal EOS calculator may dramatically reduce the number of infants who require antibiotics at birth, leading to reduced need for laboratory monitoring and improved antimicrobial stewardship. More safety data is needed.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others


  1. Polin RA . The Committee on Fetus and Newborn. Management of neonates with suspected or proven early-onset bacterial sepsis. Pediatrics 2012; 129: 1006–1015.

    Article  Google Scholar 

  2. Deleon C, Shattuck K, Jain SK . Biomarkers of neonatal sepsis. Neoreviews 2015; 16 (5): e297–e308.

    Article  Google Scholar 

  3. Verani JR, McGee L, Schrag SJ . Prevention of perinatal group b streptococcal disease: revised guidelines from CDC 2010. MMWR Recomm Rep 2010; 59 (RR-10): 1–36.

    Google Scholar 

  4. Benjamin DK, Delong ER, Steinbach WJ, Cotton CM, Walsh TJ, Clark RH . Empirical therapy for neonatal candidemia in very low birth weight infants. Pediatrics 2003; 112: 543–547.

    Article  Google Scholar 

  5. Cotton CM, Taylor S, Stoll B, Goldberg RN, Hansen NI, Sanchez PJ et al. Prolonged duration of initial empirical antibiotic treatment is associated with increased rates of necrotizing enterocolitis and death for extremely low birth weight infants. Pediatrics 2009; 123 (1): 58–66.

    Article  Google Scholar 

  6. Puopolo KM, Draper D, Wi S, Newman TB, Zupancic J, Lieberman E et al. Estimating the probability of neonatal early-onset infection on the basis of maternal risk factors. Pediatrics 2011; 128: e1155–e1162.

    Article  Google Scholar 

  7. Escobar GJ, Puopolo KM, Wi S, Turk BJ, Kuzniewicz MW, Walsh EM et al. Stratification of risk of early-onset sepsis in newborns ≥34 weeks’ gestation. Pediatrics 2014; 133: 30–36.

    Article  Google Scholar 

  8. Probability of neonatal early-onset sepsis based on maternal risk factors and the infant's clinical presentation. Kaiser Permanente. Available at: Accessed on April 2016..

  9. Shakib J, Buchi K, Smith E, Young PC . Management of newborns born to mothers with chorioamnionitis: is it time for a kinder, gentler approach? Acad Pediatr 2015; 15 (3): 340–344.

    Article  Google Scholar 

  10. Kuzniewicz MW, Walsh EM, Li S, Fischer A, Escobar GJ . Development and implementation of an early-onset sepsis calculator to guide antibiotic management in late preterm and term neonates. Jt Comm J Qual Patient Saf 2016; 42 (5): 232–239.

    Article  Google Scholar 

  11. Wortham JM, Hansen NI, Schrag SJ, Hale E, Van Meurs K, Sanchez PJ et al. Chorioamnionitis and culture-confirmed, early-onset neonatal infections. Pediatrics 2016; 137 (1): e20152323.

    Article  Google Scholar 

  12. Higgins RD, Saade G, Polin RA, Grobman WA, Buhimschi IA, Watterberg K et al. Evaluation and management of women and newborns with a maternal diagnosis of chorioamnionitis: summary of a workshop. Obstet Gynecol 2016; 127 (3): 426–436.

    Article  CAS  Google Scholar 

Download references


We appreciate the assistance of Lauren Pettit and Nicole Tipping in identifying patients for this project, as well as Catherine Baker for review of the manuscript.

Author information

Authors and Affiliations


Corresponding author

Correspondence to S Warren.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Warren, S., Garcia, M. & Hankins, C. Impact of neonatal early-onset sepsis calculator on antibiotic use within two tertiary healthcare centers. J Perinatol 37, 394–397 (2017).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:

This article is cited by


Quick links