Introduction A rational approach to managing babies at risk of early onset sepsis continues to challenge neonatal units. In August 2012 NICE published guidance on antibiotics for early onset sepsis in neonates.1 We review our unit’s performance in implementing the NICE guidance. Baseline assessment using the NICE tool had been completed previously and the NICE guideline implemented with adjustments for local use.2
Method A three month prospective audit of babies at risk of or suspected of having early onset sepsis (sepsis within 72 h of birth). The NICE guideline audit tool was used.3
Results 64 babies were audited. Every baby had a blood culture taken before commencement of antibiotics and were started on correct antibiotic doses. Initial CRP’s were taken in 95% of cases but only 61% had a repeat at 24 h.
69% of babies received antibiotics within 1 h of making clinical decision to start treatment.
88% had blood cultures available at 48 h as per local policy.
Discussion Our data demonstrates the challenge of implementing a relatively straight forward protocol of care. We excelled in some elements: initial investigation and prescribing accuracy. There was clear room for improvement in other areas.
Simple changes to practice have subsequently been implemented including revised gentamicin prescription charts and education4 to highlight the importance of timely administration of antibiotics and the evidence behind checking CRP levels.5–7 Re-audit is planned for early 2014.
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