Early onset sepsis calculator implementation is associated with reduced healthcare utilization and financial costs in late preterm and term newborns

• Published in: European journal of pediatrics Vol. 179; no. 5; pp. 727 - 734
• Main Authors: Achten, Niek B., Visser, Douwe H., Tromp, Ellen, Groot, Wim, van Goudoever, Johannes B., Plötz, Frans B.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-05-2020; Springer Nature B.V
• Subjects: Age; Anti-Bacterial Agents - therapeutic use; Antibiotics; Antimicrobial Stewardship - methods; Clinical Decision Rules; Controlled Before-After Studies; Gestation; Health services utilization; Hospital Costs - statistics & numerical data; Humans; Infant, Newborn; Infant, Premature; Laboratories; Length of Stay - economics; Length of Stay - statistics & numerical data; Medicine; Medicine & Public Health; Neonatal Sepsis - diagnosis; Neonatal Sepsis - economics; Neonatal Sepsis - prevention & control; Neonates; Original; Original Article; Pediatrics; Retrospective Studies; Risk Assessment; Sepsis; EOS calculator; Costs; Newborn; Healthcare utilization; Early-onset sepsis
• ISSN: 0340-6199; 1432-1076
• DOI: 10.1007/s00431-019-03510-9

The neonatal early onset sepsis (EOS) calculator is a novel tool for antibiotic stewardship in newborns, associated with a reduction of empiric antibiotic treatment for suspected EOS. We studied if implementation of the EOS calculator results in less healthcare utilization and lower financial costs of suspected EOS. For this, we compared two single-year cohorts of hospitalizations within 3 days after birth in a Dutch nonacademic teaching hospital, before and after implementation of the EOS calculator. All admitted newborns born at or after 35 weeks of gestation were eligible for inclusion. We analyzed data from 881 newborns pre-implementation and 827 newborns post-implementation. We found significant reductions in EOS-related laboratory tests performed and antibiotic days, associated with implementation of the EOS calculator. Mean length of hospital stay was shorter, and EOS-related financial costs were lower after implementation among term, but not among preterm newborns.
Conclusion
: In addition to the well-known positive impact on antibiotic stewardship, implementation of the EOS calculator is also clearly associated with reductions in healthcare utilization related to suspected EOS in late preterm and term newborns and with a reduction in associated financial costs among those born term.
What is Known:
•
The early-onset sepsis (EOS) calculator is a novel tool for antibiotic stewardship in newborns, associated with a reduction in empiric antibiotic treatment for suspected EOS.
What is New:
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In newborns at risk for EOS, EOS calculator implementation is associated with a significant reduction in laboratory investigations related to suspected EOS and significantly shorter stay in those born term.
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EOS calculator implementation in term newborns is associated with a mean reduction of €207 in costs for EOS-related care per admitted newborn.