Neonatal early-onset sepsis evaluations among well-appearing infants: projected impact of changes in CDC GBS guidelines

Objective:to determine (a) the proportion of asymptomatic infants born at ⩾35 weeks gestation evaluated for early-onset sepsis (eos) and exposed to postnatal antibiotics; (b) reasons for and outcomes of the evaluations, and (c) anticipated changes when applying the centers for disease control and prevention (cdc) 2010 guidelines to this study population.study design:retrospective cohort study of infants born at ⩾35 weeks gestation in 2008–2009 in a large maternity center.result:out of the 7226 infants that met the study criteria: 1062 (14.7%) were evaluated for eos and half of those evaluated, received empiric antibiotics. 70.4% of evaluations were performed owing to maternal intrapartum fever, but 23% were prompted by inadequate group b streptococcus (gbs) prophylaxis alone. three cases of blood culture-proven infection were identified.conclusion:improved approaches are needed to identify asymptomatic infants who are at risk for eos to decrease unnecessary evaluations and antibiotic exposure. transition to the 2010 cdc gbs guidelines may eliminate a quarter of eos evaluations among these infants.