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Impact of the new NICE guidance 2021 on management of early onset neonatal sepsis
  1. Laura Macaskill1,
  2. Samantha Slee2,
  3. Tim J van Hasselt2,
  4. Muhammed Naseem3,
  5. Andrew K Ewer2,
  6. Pinki Surana1
  7. Paediatric Research Across the Midlands (PRAM) Network
    1. 1 Birmingham Heartlands Hospital Neonatal Intensive Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
    2. 2 Neonatal Intensive Care, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, West Midlands, UK
    3. 3 Liver Unit, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
    1. Correspondence to Dr Laura Macaskill, Neonatal Unit, Birmingham Heartlands and Solihull (Teaching) NHS Trust, Birmingham, UK; laura.macaskill{at}

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    In April 2021, the National Institute for Health and Care Excellence (NICE) published new guidelines for neonatal infection,1 replacing the 2012 guidance. In order to reduce antibiotic usage in healthy infants, NICE modified risk factors and allowed use of Kaiser Permanente Sepsis Risk Calculator (KP-SRC)2 as an alternative with prospective audit. KP-SRC provides recommendations for antibiotics, culture with observation or observation only. Previous studies,3 including from our group,4 demonstrated significant reductions (up to 84%) in antibiotic usage on virtual application of KP-SRC compared with NICE 2012. No studies examining the impact of NICE 2021, or its effect in conjunction with KP-SRC, have yet been published.

    We performed a retrospective application of NICE 2021 using data collected from 11 neonatal units (NNUs) in the West Midlands, UK. We included all infants born ≥34 weeks’ gestation between 1 January 2020 and 29 February 2020, not directly admitted to NNU, started on antibiotics following NICE 2012 guidelines. KP-SRC was also retrospectively applied (early-onset Sepsis (EOS) incidence rate 2/1000; regional …

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    • Correction notice This paper has been corrected since it was first published. In Table 1, column 3 it should read '2012' instead of '2021'.

    • Collaborators PRAM Collaborators: Early project advice and support: Helen McDermott Local leads: Dr Hannah Vawda, Ms Sarah Kirk, Dr Moataz Badawy, Dr Pooja Siddhi. Local data collection and analysis: Megha Jagga, Oluwaseyi Alake, Canada Cherry, Benjamin Miguras, Raunak Jain, Nicola McMullan, Rawia Eltahir, 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. LM (1), SS (2), TvH (2), NM (2), AKE (2,3), PS (1), Paediatric Research Across the Midlands (PRAM) Network: (1) Birmingham Heartlands Hospital, (2) Birmingham Women’s and Children’s NHS Foundation Trust, (3) Institute of Metabolism and Systems Research, University of Birmingham. Supervision, project design, manuscript review: PS, AKE. Data analysis and manuscript: LM, SS, TvM, MN.

    • 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.