The management of the full term or near term neonate for sepsis remains problematic. From July 1, 1995 to August 31, 1995, we evaluated 110 infants with birth weights ≥ 2250 gms at risk for sepsis admitted to our nurseries at Women's and Children's Hospital of the LAC+USC Medical Center. Maternal antibiotics were given prior to delivery in 63/110 (57%) cases studied. Within the first two hours of life, blood cultures, CBC with differential and C-reactive protein (CRP) levels were drawn. Infants with CRP levels 1-3 and/or band ranges ≥ 10-24% had repeat laboratory studies at 24 and 48 hours. Any infants with band counts > 24, CRP > 3 or total WBC > 30,000 or < 5,000 were treated. All blood cultures were negative. Eleven percent (12/110) of infants developed symptoms which could be consistent with sepsis. Seven of these infants were given antibiotics and the remainder were observed with repeated lab tests. The majority of treated newborns were asymptomatic but treated following abnormal laboratory results. Table

Table 1 Number Healthy on Follow-Up
Full size table

Sixty-two of 110 infants (56%) could be followed after discharge. One asymptomatic infant with abnormal lab values was treated for 7 days, but returned within 3 days with serious disease including suspect sepsis. One asymptomatic infant with normal lab values was discharged at 48 hours and returned 12 hours later with symptoms of sepsis which responded to antibiotic therapy. 60 of 62(97%) were healthy at follow-up. In conclusion, most asymptomatic full term infants at risk for sepsis can be safely managed in the term nursery with careful observation and repetetive laboratory tests.