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Clinical Pediatrics, Vol. 42, No. 1, 11-18 (2003)
DOI: 10.1177/000992280304200102

Frequency and Timing of Symptoms in Infants Screened for Sepsis: Effectiveness of a Sepsis-Screening Pathway

Ashima Madan, MD

Stanford University School of Medicine; EI Camino Hospital, Mountain View; S-226 Grant Building, 300 Pasteur Dr., Stanford, CA 94305-5208

Marian M. Adams, MD

Stanford University School of Medicine, Stanford; EI Camino Hospital, Mountain View, CA

Alistair G. S. Philip, MD

Stanford University School of Medicine, Stanford

To determine the frequency and timing of symptoms and to evaluate the effectiveness of a sepsis-screening pathway in term and near-term infants, data were collected prospectively for a period of 1 year from December 1, 2000, to November 30, 2001. Results confirmed that a sepsis-screening pathway using a combination of at least 2 serial complete blood cell count and C-reactive protein measurements in both symptomatic and asymptomatic infants is a safe, simple strategy that prevents unnecessary treatment of infants with risk factors with antibiotics. However, most infants with presumed or suspected early-onset sepsis are symptomatic. Routine treatment of asymptomatic infants with risk factors or prior treatment with intrapartum antibiotics is unnecessary. A combined approach of screening in the presence of risk factors and /or symptoms of sepsis and adequate follow-up for infants discharged at less than 72 hours of age may help reduce unnecessary treatment of infants with antibiotics.


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