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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : -55 مورد

Approach to evaluating the risk of early-onset sepsis (EOS) and determining need for empiric antibiotic therapy in neonates born <35 weeks gestation

Approach to evaluating the risk of early-onset sepsis (EOS) and determining need for empiric antibiotic therapy in neonates born <35 weeks gestation
This figure summarizes our suggested approach to risk assessment for EOS in neonates born <35 weeks gestation. The neonate's risk can be categorized as increased or low based upon the circumstances leading to preterm birth and their clinical stability. Neonates who are assessed as having increased risk of EOS generally warrant laboratory evaluation and empiric antibiotic therapy. For additional details, including a discussion of the evidence supporting this approach, refer to related UpToDate content on bacterial sepsis in neonates.

CSF: cerebrospinal fluid; GBS: group B Streptococcus; IAP: intrapartum antibiotic prophylaxis; LP: lumbar puncture.

* Adequate GBS IAP is defined as the administration of penicillin G, ampicillin, or cefazolin ≥4 hours before delivery. For details regarding indications for IAP, refer to related UpToDate content on prevention of GBS in pregnancy.

¶ Blood and CSF cultures should be obtained before starting empiric antibiotics. However, LP should not be performed if the procedure would compromise the neonate's condition. Antibiotic therapy should not be deferred because of procedure delays.

Δ For details regarding management with empiric antibiotics, refer to related UpToDate content on treatment of neonatal GBS and neonatal sepsis.

◊ For low-risk neonates who subsequently develop severe clinical instability or signs of severe sepsis (eg, shock), it is generally appropriate to perform laboratory evaluation for sepsis and administer empiric antibiotics, as for neonates at increased risk.

References:
  1. Puopolo KM, Lynfield R, Cummings JJ, et al. Management of Infants at Risk for Group B Streptococcal Disease. Pediatrics 2019; 144.
  2. Puopolo KM, Benitz WE, Zaoutis TE, et al. Management of Neonates Born at ≤34 6/7 Weeks' Gestation With Suspected or Proven Early-Onset Bacterial Sepsis. Pediatrics 2018; 142: e20182896.
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