Mesvaht et al analyzed factors associated with failure of empirical antibiotic therapy in a neonate with early onset sepsis. They developed a decision tree for factors known at 24 hours after birth. The authors are from Tartu University and Tallinn Children's Hospital in Estonia.
Empirical antibiotic therapy: penicillin/ampicillin plus gentamicin
Parameters known at 24 hours after birth:
(1) blood glucose in mmol/L
(2) C-reactive protein in mg/L
(3) gestational age at birth in weeks
(4) birthweight in grams
(5) white blood cell count in 10^9/L
(6) platelet count in 10^9/L
|
Glucose |
CRP |
GA weeks |
Weight |
WBC Count |
Platelet Count |
prob failure |
|
< 2.55 |
>= 1.35 |
NA |
NA |
NA |
NA |
0.53 |
|
< 2.55 |
< 1.35 |
< 27 |
NA |
NA |
NA |
0.57 |
|
< 2.55 |
< 1.35 |
>= 27 |
NA |
NA |
NA |
0 |
|
>= 2.55 |
NA |
NA |
< 677.5 |
NA |
NA |
0.36 |
|
>= 2.55 |
NA |
NA |
>= 677.5 |
>= 8.25 |
NA |
0.20 |
|
>= 2.55 |
NA |
NA |
>= 677.5 |
< 8.25 |
>= 142.5 |
0.08 |
|
>= 2.55 |
NA |
NA |
>= 677.5 |
< 8.25 |
< 142.5 |
0.42 |
where:
• A glucose of 2.55 mmol/L is around 46 mg/dL.
A probability of treatment failure >= 0.30 was defined as treatment failure.
Specialty: Pedatrics, Infectious Diseases
