8/12/2019 Newborn Sepsis Guideline

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8/12/2019 Newborn Sepsis Guideline

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Full Evaluation and Initiation of Therapy

•  CBC w/ differential, CRP, blood culture, serum glucose •  Therapy: Ampicillin and Gentamicin (see page 1) 

•  Follow up serial lab screening as indicated

•  Length of treatment will depend on clinical course,culture results and lab studies.

•  Consider CXR, lumbar puncture, electrolytes, ionized Capending clinical course

Clinical Guideline to Evaluate Newborns at Risk for Sepsis

Signs or symptoms of sepsis

Yes

 Algori thms are not intended to replace providers ’ clinical judgmentor to establish a single protocol. Some clinical situations may not

be adequately addressed in this guideline. Clinicians shoulddocument management variations or plans o f care as indicated. Lastrevised November, 2011 by the Newborn Nursery GBS sub-committee. Ref:MMWR Prevention of Perinatal Group B Steptococcal Disease, RevisedGuidelines from CDC, 2010. Nov. 19, 2010/Vol.59/No.RR-10 

Maternal Chorioamnionit is

Yes

No

No

Limited Evaluation

•  Observation for > 48 hours; vitals q 4 hours during stay

•  Blood culture, CBC and CRP at birth; CBC, CRP at 12hrs 

•   Additional CBC and CRP screening may be considered

•  Observation for > 48 hours; vitals q 4 hours during stay

• CBC and CRP at birth and 12 hours

 Any of the fol lowing?

•  Rupture of membranes >18 hrs

•  Maternal temp > 38.0 C

•  < 37 weeks gestation

ROUTINE NEWBORN CARENo

No

Yes

Yes

Mother received intravenous

penicill in, ampic illin or cefazolin > 4hours before delivery

**GBS intrapartum p rophylaxis indicated for:

•  GBS + screening culture in late gestation duringcurrent pregnancy except when delivery occurs by C-

section with in tact membranes before onset of labor•  GBS bacteruria during current pregnancy

•  Previous infant with invasive GBS disease

•  Unknown GBS status and any of the following- < 37weeks gestation, ROM >18 hrs, or maternal fever (>38.0 C

GBS prophylaxis indicated formother?**

No

Yes

•  Observation for > 48 hours; discharge may occur after24 hours if adequate home observation and access tomedical care is assured.