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.