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In the first week of life, 15% to 20% of term and near-term newborns are evaluated for sepsis, and 5% to 8% are empirically treated for sepsis, despite a concurrent sepsis rate of only 0.3 to 0.8 per 1000 births. Existing guidelines are not specific in predicting early-onset sepsis (EOS). Investigators hypothesized that using a Bayesian approach to individualize the risk for sepsis, added to existing guidelines, could reduce rates of blood culture and unnecessary antibiotic exposure in neonates.
The authors used this approach for 204,485 infants born at ≥35 weeks' gestation at a hospital in one healthcare system during three sequential periods spanning 6 years. In the first (baseline) period, clinical care was informed by the Centers for Dis…