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- W4253352241 abstract "Journal of Paediatrics and Child HealthVolume 51, Issue 7 p. 741-742 Heads UpFree Access Guidelines for early-onset sepsis make things worse First published: 01 July 2015 https://doi.org/10.1111/jpc.12942_2AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Guidelines are not gospels; they are written by humans with all their human failings. They need to be evaluated. In August 2012, the National Institute of Health and Clinical Excellence (NICE) published guidelines on the management of early-onset neonatal sepsis.1 These recommended measuring serum C-reactive protein (CRP) when antibiotics were started and 18–24 h later, and stopping antibiotics after 36 h if the baby is well, blood culture negative and the CRP ‘reassuring’. One UK neonatal unit previously measured CRP at time of starting antibiotics but stopped antibiotics after 2–3 days if cultures were negative, without repeating the CRP. They switched to the NICE guidelines and evaluated the effect in babies born over a 4-month period before (A) and after (B) introducing the guidelines (see Figure).2 The mean duration of hospital stay increased from 2.1 days (A) to 3.2 days (B) and prolonged intravenous antibiotic use increased (22.2% of group B babies received 5 days and 11% received 7 days). More babies in B had lumbar punctures (1 vs. 8). No babies had sepsis. When the pre-test probability of sepsis is extremely low, as in a well baby with negative blood cultures, using a test like CRP, despite its reasonable sensitivity and specificity, is almost certain to do more harm than good. References 1Available from: https://www.nice.org.uk/guidance/cg149 [accessed March 15]. 2Naydeva-Grigorova T et al. Arch. Dis. Child. Fetal Neonatal Ed. 2015; 100: F93– 94. Reviewer: David Isaacs (david.isaacs@health.nsw.gov.au) Volume51, Issue7July 2015Pages 741-742 ReferencesRelatedInformation" @default.
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- W4253352241 date "2015-07-01" @default.
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- W4253352241 title "Guidelines for early-onset sepsis make things worse" @default.
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