The management of the late preterm and term newborn with early onset infection anno 2022

Abstract

Early onset sepsis (EOS) is a common source of admission to a neonatal intensive care unit (NICU). Identifying children at risk for EOS remains essential but challenging because of aspecific clinical signs and poor predictive value of blood tests. Although the incidence of EOS has decreased over the past twenty years, primarily due to the introduction of intrapartum antibiotic prophylaxis, many children with low risk of EOS are evaluated and are treated unnecessarily. This leads to a separation of mother and child, an increase in health care costs, not to mention the side effects of antibiotics in future childhood. We conducted a review of the literature regarding the latest guidelines, inflammatory markers and tools that can help us in the evaluation and management of newborns at risk of EOS. The goal of this article is to discuss an evidence-based approach to the assessment and management of newborns > 35 weeks presenting with signs of possible EOS. An emerging trend is serial clinical examination which is promising to reduce newborn assessments and treatment. In all cases, EOS are unpredictable and clinical vigilance is essential over time.