{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:42:47Z","timestamp":1792424567698,"version":"4.5.0"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:p>\n            Objective\u2003The objective of this study was to evaluate the success and safety of an antimicrobial stewardship protocol for neonates admitted with respiratory distress at birth.<\/jats:p><jats:p>\n            Study Design\u2003A retrospective cohort analysis of all infants admitted to the neonatal intensive care unit (NICU) with respiratory distress from January 2013 to February 2018 was conducted. In April 2016, an antimicrobial stewardship protocol was implemented, dividing neonates into two groups: maternal indications for delivery (no infectious risk factors for early-onset sepsis [EOS]) and fetal indications (risk factors present) for delivery. Neonates with risk factors for EOS were started on empiric antibiotics, those who lacked risk factors were observed. Paired sample t-test and descriptive statistics were used to compare the pre- and postprotocol implementation.<\/jats:p><jats:p>\n            Results\u2003There were no missed cases of EOS in our study. Management with empiric antibiotics decreased from 95 to 41% of neonates with respiratory distress after initiation of the protocol. Newborns with a lower mean (\u00b1standard errors of the mean [SEM]) gestational age were more likely to receive empiric antibiotics (35.1\u2009\u00b1\u20090.4 [range: 23\u201342 weeks] vs. 37.7\u2009\u00b1\u20090.2 weeks [range: 24\u201342 weeks]; p\u2009&lt;\u20090.05). Similar findings were seen for neonates with lower mean birth weights (2,627\u2009\u00b1\u200977 [range: 390\u20135,440\u2009g] vs. 3,078\u2009\u00b1\u200951\u2009g [range: 620\u20136,260\u2009g]; p\u2009&lt;\u20090.05).<\/jats:p><jats:p>\n            Conclusion\u2003The antibiotic stewardship protocol safely reduces the administration of empiric antibiotics to symptomatic neonates without missing any cases of sepsis.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0040-1717070","type":"journal-article","created":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T22:50:42Z","timestamp":1600469442000},"page":"444-448","source":"Crossref","is-referenced-by-count":14,"title":["Are Early-Onset Sepsis Evaluations and Empiric Antibiotics Mandatory for All Neonates Admitted with Respiratory Distress?"],"prefix":"10.1055","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7895-8142","authenticated-orcid":false,"given":"Ivana","family":"Capin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology, Staten Island University Hospital, Northwell Health, Staten Island, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Autumn","family":"Hinds","sequence":"additional","affiliation":[{"name":"SUNY Downstate College of Medicine, Brooklyn, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridgit","family":"Vomero","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology, Staten Island University Hospital, Northwell Health, Staten Island, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Roth","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology, Staten Island University Hospital, Northwell Health, Staten Island, New York"},{"name":"Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Hempstead, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Blau","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology, Staten Island University Hospital, Northwell Health, Staten Island, New York"},{"name":"Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Hempstead, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,9,18]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"e20162013","DOI":"10.1542\/peds.2016-2013","article-title":"Epidemiology of invasive early-onset neonatal sepsis, 2005 to 2014","volume":"138","author":"S J Schrag","year":"2016","journal-title":"Pediatrics"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1128\/CMR.00031-13","article-title":"Early-onset neonatal sepsis","volume":"27","author":"K A Simonsen","year":"2014","journal-title":"Clin Microbiol Rev"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1542\/peds.110.2.285","article-title":"Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network","volume":"110","author":"B J Stoll","year":"2002","journal-title":"Pediatrics"},{"issue":"07","key":"ref4","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1097\/01.inf.0000168749.82105.64","article-title":"Very low birth weight preterm infants with early onset neonatal sepsis: the predominance of gram-negative infections continues in the National Institute of Child Health and Human Development Neonatal Research Network, 2002-2003","volume":"24","author":"B J Stoll","year":"2005","journal-title":"Pediatr Infect Dis J"},{"issue":"12","key":"ref5","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1111\/apa.12764","article-title":"Meta-analysis shows that infants who have suffered neonatal sepsis face an increased risk of mortality and severe complications","volume":"103","author":"S E Bakhuizen","year":"2014","journal-title":"Acta Paediatr"},{"issue":"06","key":"ref6","doi-asserted-by":"crossref","first-page":"e20162013","DOI":"10.1542\/peds.2016-2013","article-title":"Epidemiology of invasive early-onset neonatal sepsis, 2005 to 2014","volume":"138","author":"S J Schrag","year":"2016","journal-title":"Pediatrics"},{"issue":"05","key":"ref7","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1542\/peds.2010-2217","article-title":"Early onset neonatal sepsis: the burden of group B streptococcal and E. coli disease continues","volume":"127","author":"B J Stoll","year":"2011","journal-title":"Pediatrics"},{"issue":"05","key":"ref8","doi-asserted-by":"crossref","first-page":"e20170925","DOI":"10.1542\/peds.2017-0925","article-title":"Identification of extremely premature infants at low risk for early-onset sepsis","volume":"140","author":"K M Puopolo","year":"2017","journal-title":"Pediatrics"},{"issue":"06","key":"ref10","doi-asserted-by":"crossref","first-page":"e77","DOI":"10.1542\/peds.103.6.e77","article-title":"Risk factors for early-onset group B streptococcal sepsis: estimation of odds ratios by critical literature review","volume":"103","author":"W E Benitz","year":"1999","journal-title":"Pediatrics"},{"issue":"04","key":"ref11","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1056\/NEJMoa020205","article-title":"A population-based comparison of strategies to prevent early-onset group B streptococcal disease in neonates","volume":"347","author":"S J Schrag","year":"2002","journal-title":"N Engl J Med"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1097\/MOP.0000000000000338","article-title":"Adverse consequences of neonatal antibiotic exposure","volume":"28","author":"C M Cotten","year":"2016","journal-title":"Curr Opin Pediatr"},{"issue":"05","key":"ref13","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1016\/j.jpeds.2011.05.033","article-title":"Prolonged initial empirical antibiotic treatment is associated with adverse outcomes in premature infants","volume":"159","author":"V S Kuppala","year":"2011","journal-title":"J Pediatr"},{"issue":"03","key":"ref14","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.jpeds.2011.02.035","article-title":"Antibiotic exposure in the newborn intensive care unit and the risk of necrotizing enterocolitis","volume":"159","author":"V N Alexander","year":"2011","journal-title":"J Pediatr"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.jpeds.2018.07.036","article-title":"Early antibiotic exposure and adverse outcomes in preterm, very low birth weight infants","volume":"203","author":"J B Cantey","year":"2018","journal-title":"J Pediatr"},{"issue":"03","key":"ref16","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1093\/aje\/kwq400","article-title":"Antibiotic exposure by 6 months and asthma and allergy at 6 years: findings in a cohort of 1,401 US children","volume":"173","author":"K R Risnes","year":"2011","journal-title":"Am J Epidemiol"},{"issue":"05","key":"ref17","doi-asserted-by":"crossref","first-page":"e0125448","DOI":"10.1371\/journal.pone.0125448","article-title":"Antibiotics in early life alter the gut microbiome and increase disease incidence in a spontaneous mouse model of autoimmune insulin-dependent diabetes","volume":"10","author":"S Candon","year":"2015","journal-title":"PLoS One"},{"issue":"01","key":"ref18","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1542\/peds.2007-3423","article-title":"Prolonged duration of initial empirical antibiotic treatment is associated with increased rates of necrotizing enterocolitis and death for extremely low birth weight infants","volume":"123","author":"C M Cotten","year":"2009","journal-title":"Pediatrics"},{"issue":"09","key":"ref19","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1086\/502270","article-title":"Duration of empiric antibiotics for suspected early-onset sepsis in extremely low birth weight infants","volume":"24","author":"L Cordero","year":"2003","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"02","key":"ref20","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.jpeds.2005.03.054","article-title":"Oral probiotics prevent necrotizing enterocolitis in very low birth weight neonates","volume":"147","author":"A Bin-Nun","year":"2005","journal-title":"J Pediatr"},{"issue":"04","key":"ref21","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1542\/peds.2007-3007","article-title":"Oral probiotics prevent necrotizing enterocolitis in very low birth weight preterm infants: a multicenter, randomized, controlled trial","volume":"122","author":"H C Lin","year":"2008","journal-title":"Pediatrics"},{"issue":"34","key":"ref22","doi-asserted-by":"crossref","first-page":"12522","DOI":"10.1073\/pnas.1409497111","article-title":"Patterned progression of bacterial populations in the premature infant gut","volume":"111","author":"P S La Rosa","year":"2014","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"01","key":"ref23","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1186\/s40168-017-0377-0","article-title":"Impact of prematurity and nutrition on the developing gut microbiome and preterm infant growth","volume":"5","author":"A Grier","year":"2017","journal-title":"Microbiome"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/2049-2618-2-38","article-title":"Development of the preterm infant gut microbiome: a research priority","volume":"2","author":"M W Groer","year":"2014","journal-title":"Microbiome"},{"issue":"01","key":"ref25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/2049-2618-2-1","article-title":"Microbes in the neonatal intensive care unit resemble those found in the gut of premature infants","volume":"2","author":"B Brooks","year":"2014","journal-title":"Microbiome"},{"issue":"12","key":"ref26","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1038\/jp.2017.137","article-title":"Anti-microbial stewardship: antibiotic use in well-appearing term neonates born to mothers with chorioamnionitis","volume":"37","author":"N Money","year":"2017","journal-title":"J Perinatol"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1717070.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,26]],"date-time":"2022-02-26T00:53:58Z","timestamp":1645836838000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1717070"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,18]]},"references-count":25,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2022,2,25]]},"published-print":{"date-parts":[[2022,3]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1717070","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,18]]}}}