{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:42:05Z","timestamp":1792424525639,"version":"4.5.0"},"reference-count":30,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009459","name":"Society for Anthropological Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009459","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["thelancet.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["eClinicalMedicine"],"published-print":{"date-parts":[[2025,9]]},"DOI":"10.1016\/j.eclinm.2025.103419","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T08:37:07Z","timestamp":1754987827000},"page":"103419","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":5,"special_numbering":"C","title":["Safety and effectiveness of the early-onset sepsis calculator to reduce antibiotic exposure in at-risk newborns: a cluster-randomised controlled trial"],"prefix":"10.1016","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8977-8422","authenticated-orcid":false,"given":"Bo M.","family":"van der Weijden","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6955-498X","authenticated-orcid":false,"given":"Sanne W.C.M.","family":"Janssen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marijke C.","family":"van der Weide","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renske J.P.M.","family":"Cornelisse-van Vugt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6448-5631","authenticated-orcid":false,"given":"Gavin W.","family":"ten Tusscher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire A.M.","family":"Lutterman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arvid W.A.","family":"Kamps","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen M.","family":"Lorente Flores","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3158-4996","authenticated-orcid":false,"given":"Jeroen","family":"Hol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henri\u00ebtte","family":"van Laerhoven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten","family":"Rijpert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia A.","family":"Oeij","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene A.M.","family":"Schiering","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia A.","family":"Obermann-Borst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douwe H.","family":"Visser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisanne M.","family":"van Leeuwen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9 F.","family":"Kornelisse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annemarie M.C.","family":"van Rossum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3246-5083","authenticated-orcid":false,"given":"Merijn W.","family":"Bijlsma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frans B.","family":"Pl\u00f6tz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0286-4393","authenticated-orcid":false,"given":"Niek B.","family":"Achten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"10449","key":"10.1016\/j.eclinm.2025.103419_bib1","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/S0140-6736(24)00495-1","article-title":"Neonatal bacterial sepsis","volume":"404","author":"Strunk","year":"2024","journal-title":"Lancet"},{"issue":"11","key":"10.1016\/j.eclinm.2025.103419_bib2","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.43691","article-title":"Analysis of antibiotic exposure and early-onset neonatal sepsis in Europe, North America, and Australia","volume":"5","author":"Giannoni","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"6","key":"10.1016\/j.eclinm.2025.103419_bib3","article-title":"Incidence of antibiotic exposure for suspected and proven neonatal early-onset sepsis between 2019 and 2021: a retrospective, multicentre study","volume":"13","author":"van Veen","year":"2024","journal-title":"Antibiotics (Basel)"},{"issue":"October","key":"10.1016\/j.eclinm.2025.103419_bib4","first-page":"1","article-title":"Culture-negative early-onset neonatal sepsis \u2014 at the crossroad between efficient sepsis care and antimicrobial stewardship","volume":"6","author":"Klingenberg","year":"2018","journal-title":"Front Pediatr"},{"key":"10.1016\/j.eclinm.2025.103419_bib5","series-title":"Neonatal infection (early onset): antibiotics for prevention and treatment (CG149)","year":"2012"},{"issue":"2","key":"10.1016\/j.eclinm.2025.103419_bib6","doi-asserted-by":"crossref","first-page":"F185","DOI":"10.1136\/archdischild-2014-307776","article-title":"Management of neonatal early onset sepsis (CG149): compliance of neonatal units in the UK with NICE recommendations","volume":"100","author":"Mukherjee","year":"2015","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"2","key":"10.1016\/j.eclinm.2025.103419_bib7","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1136\/archdischild-2018-316777","article-title":"Screening for early onset neonatal sepsis: NICE guidance-based practice versus projected application of the kaiser permanente sepsis risk calculator in the UK population","volume":"105","author":"Goel","year":"2020","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"1","key":"10.1016\/j.eclinm.2025.103419_bib8","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1038\/s41467-022-28525-z","article-title":"Effects of early-life antibiotics on the developing infant gut microbiome and resistome: a randomized trial","volume":"13","author":"Reyman","year":"2022","journal-title":"Nat Commun"},{"issue":"12","key":"10.1016\/j.eclinm.2025.103419_bib9","doi-asserted-by":"crossref","first-page":"5191","DOI":"10.1007\/s00431-024-05775-1","article-title":"Neonatal and early infancy antibiotic exposure is associated with childhood atopic dermatitis, wheeze and asthma","volume":"183","author":"Raty","year":"2024","journal-title":"Eur J Pediatr"},{"issue":"10","key":"10.1016\/j.eclinm.2025.103419_bib10","doi-asserted-by":"crossref","first-page":"2669","DOI":"10.1016\/j.jaip.2024.06.018","article-title":"Use of antibiotics in infancy and asthma in childhood: Confounded or causal relationship? A critical review of the literature","volume":"12","author":"Gold","year":"2024","journal-title":"J Allergy Clin Immunol Pract"},{"issue":"2","key":"10.1016\/j.eclinm.2025.103419_bib11","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1001\/jamapediatrics.2019.4794","article-title":"Association between use of multiple classes of antibiotic in infancy and allergic disease in childhood","volume":"174","author":"Zven","year":"2020","journal-title":"JAMA Pediatr"},{"issue":"6","key":"10.1016\/j.eclinm.2025.103419_bib12","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1177\/2042098614554919","article-title":"Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem","volume":"5","author":"Llor","year":"2014","journal-title":"Ther Adv Drug Saf"},{"issue":"5","key":"10.1016\/j.eclinm.2025.103419_bib13","doi-asserted-by":"crossref","first-page":"e1155","DOI":"10.1542\/peds.2010-3464","article-title":"Estimating the probability of neonatal early-onset infection on the basis of maternal risk factors","volume":"128","author":"Puopolo","year":"2011","journal-title":"Pediatrics"},{"issue":"1","key":"10.1016\/j.eclinm.2025.103419_bib14","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1542\/peds.2013-1689","article-title":"Stratification of risk of early-onset sepsis in newborns >\/= 34 weeks\u2019 gestation","volume":"133","author":"Escobar","year":"2014","journal-title":"Pediatrics"},{"issue":"4","key":"10.1016\/j.eclinm.2025.103419_bib15","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1001\/jamapediatrics.2016.4678","article-title":"A quantitative, risk-based approach to the management of neonatal early-onset sepsis","volume":"171","author":"Kuzniewicz","year":"2017","journal-title":"JAMA Pediatr"},{"issue":"11","key":"10.1016\/j.eclinm.2025.103419_bib16","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1001\/jamapediatrics.2019.2825","article-title":"Association of use of the neonatal early-onset Sepsis calculator with reduction in antibiotic therapy and safety: a systematic review and meta-analysis","volume":"173","author":"Achten","year":"2019","journal-title":"JAMA Pediatr"},{"issue":"3","key":"10.1016\/j.eclinm.2025.103419_bib17","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1136\/archdischild-2020-321489","article-title":"Implementation of an adapted sepsis risk calculator algorithm to reduce antibiotic usage in the management of early onset neonatal sepsis: a multicentre initiative in Wales, UK","volume":"107","author":"Goel","year":"2022","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"10","key":"10.1016\/j.eclinm.2025.103419_bib18","article-title":"Barriers and facilitators to the implementation of the early-onset sepsis calculator: a multicenter survey study","volume":"10","author":"van Veen","year":"2023","journal-title":"Children (Basel)"},{"key":"10.1016\/j.eclinm.2025.103419_bib19","article-title":"Sensitivity of the kaiser permanente early-onset sepsis calculator: a systematic review and meta-analysis","volume":"19","author":"Pettinger","year":"2019","journal-title":"eClinicalMedicine"},{"key":"10.1016\/j.eclinm.2025.103419_bib20","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2021.101270","article-title":"Neonatal early-onset infections: comparing the sensitivity of the neonatal early-onset Sepsis calculator to the Dutch and the updated NICE guidelines in an observational cohort of culture-positive cases","volume":"44","author":"Snoek","year":"2022","journal-title":"eClinicalMedicine"},{"key":"10.1016\/j.eclinm.2025.103419_bib21","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.jpeds.2021.01.065","article-title":"Stratification of culture-proven early-onset sepsis cases by the neonatal early-onset sepsis calculator: an individual patient data meta-analysis","volume":"234","author":"Achten","year":"2021","journal-title":"J Pediatr"},{"issue":"5","key":"10.1016\/j.eclinm.2025.103419_bib22","doi-asserted-by":"crossref","first-page":"e134","DOI":"10.1016\/S1473-3099(20)30490-4","article-title":"Technical assessment of the neonatal early-onset sepsis risk calculator","volume":"21","author":"Benitz","year":"2021","journal-title":"Lancet Infect Dis"},{"key":"10.1016\/j.eclinm.2025.103419_bib23","series-title":"Neonatal infection: antibiotics for prevention and treatment (NG195)","year":"2021"},{"issue":"2","key":"10.1016\/j.eclinm.2025.103419_bib24","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2022-069253","article-title":"Evaluating safety and effectiveness of the early-onset sepsis calculator to reduce antibiotic exposure in Dutch at-risk newborns: a protocol for a cluster randomised controlled trial","volume":"13","author":"van der Weijden","year":"2023","journal-title":"BMJ Open"},{"key":"10.1016\/j.eclinm.2025.103419_bib25","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.e5661","article-title":"Consort 2010 statement: extension to cluster randomised trials","volume":"345","author":"Campbell","year":"2012","journal-title":"BMJ"},{"key":"10.1016\/j.eclinm.2025.103419_bib26","series-title":"Preventie en behandeling van early-onset neonatale infecties (Adaptatie van de NICE-richtlijn)","year":"2017"},{"key":"10.1016\/j.eclinm.2025.103419_bib27","series-title":"NethMap 2024: consumption of antimicrobial agents and antimicrobial resistance among medically important bacteria in the Netherlands in 2023: Rijksinstituut voor Volksgezondheid en Milieu (RIVM)","author":"de Greeff","year":"2024"},{"issue":"12","key":"10.1016\/j.eclinm.2025.103419_bib28","doi-asserted-by":"crossref","first-page":"2549","DOI":"10.1111\/apa.15391","article-title":"Neonatal early-onset sepsis calculator recommended significantly less empiric antibiotic treatment than national guidelines","volume":"109","author":"van der Weijden","year":"2020","journal-title":"Acta Paediatr"},{"issue":"3","key":"10.1016\/j.eclinm.2025.103419_bib29","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1111\/apa.15488","article-title":"Multicentre study found that adherence to national antibiotic recommendations for neonatal early-onset sepsis was low","volume":"110","author":"van der Weijden","year":"2021","journal-title":"Acta Paediatr"},{"issue":"4","key":"10.1016\/j.eclinm.2025.103419_bib30","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2023-065267","article-title":"Update to the neonatal early-onset Sepsis calculator utilizing a contemporary cohort","volume":"154","author":"Kuzniewicz","year":"2024","journal-title":"Pediatrics"}],"container-title":["eClinicalMedicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2589537025003517?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2589537025003517?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T20:08:37Z","timestamp":1762632517000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2589537025003517"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":30,"alternative-id":["S2589537025003517"],"URL":"https:\/\/doi.org\/10.1016\/j.eclinm.2025.103419","relation":{},"ISSN":["2589-5370"],"issn-type":[{"value":"2589-5370","type":"print"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Safety and effectiveness of the early-onset sepsis calculator to reduce antibiotic exposure in at-risk newborns: a cluster-randomised controlled trial","name":"articletitle","label":"Article Title"},{"value":"eClinicalMedicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.eclinm.2025.103419","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Author(s). Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"103419"}}