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Clinical Pediatrics, Vol. 29, No. 8, 445-447 (1990)
DOI: 10.1177/000992289002900805

Superficial Cultures in Neonatal Sepsis Evaluations

Impact on Antibiotic Decision Making

Terrance J. Zuerlein, MD

Department of Pediatrics, Section of Neonatology, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri

Jay C. Butler, MD

Epidemic Intelligence Service, Centers for Disease Control, Atlanta, Georgia

Thomas D. Yeager, MD

Department of Pediatrics, Vanderbilt University Hospital, Nashville, Tennessee

The authors performed a retrospective analysis of neonatal superficial cultures and their effect on antimicrobial decision making during a nine-month period at Nashville General Hospital. They obtained and reviewed charts of infants (n=66) having paired superficial (skin and/or gastric aspirate) and deep (blood and cerebrospinal fluid) cultures for the evaluation of early-onset sepsis. Superficial cultures were positive for pathogens (any streptococcus or enteric gram-negative) in 15% (10/66) of cases. Antimicrobial decision making was affected in only one of these cases, and in a seemingly inappropriate manner. In summary, there was no evidence or review that superficial cultures used in sepsis evaluation influenced physician antimicrobial decision making; in one case they may have led to unnecessary antibiotic exposure.


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S. R. Allen
Management of Asymptomatic Term Neonates Whose Mothers Received Intrapartum Antibiotics--Part 2: Diagnostic Tests and Management Strategies
Clinical Pediatrics, November 1, 1997; 36(11): 617 - 624.
[Abstract] [PDF]