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Impact of neonatal sepsis calculator in West Midlands (UK)
  1. Tim J van Hasselt1,
  2. Helen McDermott2,
  3. Pinki Surana2,
  4. Rawia Eltahir3,
  5. Laura Macaskill4,
  6. Raunak Jain5,
  7. Nicola McMullan6,
  8. Samantha Slee1,
  9. Megha Jagga7,
  10. Muhammed Naseem2,
  11. Oluwaseyi Alake7,
  12. Canada Cherry8,
  13. Benjamin Miguras9,
  14. Andrew K Ewer7,10
  15. Paediatric Research Across the Midlands (PRAM) Network
  1. 1 Neonatal Intensive Care Unit, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
  2. 2 Neonatal Intensive Care Unit, Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  3. 3 Neonatal Unit, Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, Shropshire, UK
  4. 4 Neonatal Unit, City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
  5. 5 University College London, London, UK
  6. 6 Neonatal Unit, Dudley Group of Hospitals NHS Trust, Dudley, West Midlands, UK
  7. 7 Neonatal Intensive Care Unit, Birmingham Women's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
  8. 8 Neonatal Unit, Good Hope Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  9. 9 Neonatal Intensive Care Unit, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
  10. 10 Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
  1. Correspondence to Dr Tim J van Hasselt, Neonatal Intensive Care Unit, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent ST4 6QG, UK; t.vanhasselt{at}nhs.net

https://doi.org/10.1136/archdischild-2020-320862

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    The Kaiser Permanente Sepsis Risk Calculator (KP-SRC) was developed to predict early-onset neonatal sepsis (EOS), using continuous variables (local EOS incidence rates, maternal factors, infant well-being) to guide decision making.1

    KP-SRC has been adopted in Plymouth and Wales, reducing antibiotic use by up to 84%2 3 compared with using National Institute for Health and Care Excellence (NICE) guidelines. This may reduce antibiotic resistance, dysbiosis,2 invasive procedures and mother–baby separation, although some safety concerns have been raised.4

    We performed a virtual application of the KP-SRC versus NICE guidance on postnatal antibiotic usage and length of stay, using anonymised clinical data collected prospectively across 11 neonatal units in the West Midlands, UK. The Health Research Authority confirmed ethical approval was not required.

    All infants born ≥34 weeks’ gestation between 1 January 2020 and 29 February 2020 who were commenced on antibiotics for EOS and managed as per NICE guidelines were included. Those admitted to the neonatal unit prior to commencing antibiotics were excluded.

    The KP-SRC …

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    Footnotes

    • Twitter @94naseem

    • Collaborators PRAM Collaborators: Local leads: Dr Hannah Vawda, Ms Sarah Kirk, Dr Moataz Badawy, Dr Pooja Siddhi. Local data collection and analysis: Dr Sebastian Brown. Local data collection: Dr Mshail Mahmoud, Dr Vishanna Balbirsingh, Dr Catherine Lomax, Dr Emmeline Parfitt-Roche, Dr Andrew Pearce, Dr Lindsay Mulligan, Dr Afza Sadiq. Initial pilot work: Dr Sonia Goyal. Local Consultant Leads: Dr Kate Palmer, Dr Chandan Gupta, Dr Mohammed Buhary, Dr Michael Plunkett, Dr Paul Watson, Dr Robert Negrine, Dr Penny Broggio, Dr Raghu Krishnamurthy, Dr Cathryn Seagrave.

    • Contributors This study is a collaboration lead by Paediatric Research Across the Midlands (PRAM), the West Midlands trainee-led regional research group. TJvH (1), HM (2), PS (2), RE (3), LM (4), RJ (5), NM (6), SS (1), MJ (7), MN (2), OA (7), CC (2), BM (8), AKE (7, 9), Paediatric Research Across the Midlands (PRAM) Network: (1) University Hospitals of North Midlands, (2) University Hospitals Birmingham, (3) The Shrewsbury and Telford Hospital NHS Trust, (4) Sandwell and West Birmingham Hospitals NHS Trust, (5) University College London, (6) The Dudley Group NHS Foundation Trust, (7) Birmingham Women’s and Children’s NHS Foundation Trust, (8) Royal Wolverhampton NHS Trust, (9) Institute of Metabolism and Systems Research, University of Birmingham. Project design, analysis, manuscript: TJvH, HM; supervision, project design, manuscript review: PS, AKE; local lead, data collection, manuscript: RE, LM, NM, SS, MJ, OA, CC, BM; data collection, manuscript: MN; data analysis, manuscript: RJ.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.