# Neonatal early-onset sepsis calculator Resource · id `maternal:neonatal-eos-calculator` · Maternal & Newborn Atlas · release `fc5a600ec7387e71` (public) > General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here. The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations. Browse, life stage: Newborn Browse, care area: Preterm and sick newborns ## In plain language A risk tool for newborns born at 35 weeks or later. It combines objective information available at birth with the baby's clinical condition to estimate the risk of early-onset sepsis, so that fewer well babies have blood tests and antibiotics. In one large US health system, its use went with less blood culture testing and less early antibiotic use, and no sign of harm in the 2017 report. ## Technical summary Resource, tool. The 2017 paper (PubMed abstract) describes multivariable prediction models for estimating the risk of early-onset sepsis among late preterm and term infants from objective data at birth and the newborn's clinical status, and reports their use in a before-and-after comparison; it is not a randomised trial. A 2024 update was published in Pediatrics; it is an identity-only reference and its content was not read. No model coefficients, thresholds or recommended actions are recorded here. ## Claims, with the population each applies to ## Context: Infants born at 35 weeks or later in a Kaiser Permanente Northern California cohort (early-onset sepsis risk models) Recipient: Newborn; Population: 204,485 infants born at 35 weeks' gestation or later at Kaiser Permanente Northern California hospitals between January 1, 2010, and December 31, 2015. The models estimate sepsis risk among late preterm and term infants from objective data available at birth and the newborn's clinical status. The abstract does not apply them to infants born before 35 weeks.; Care setting: Hospitals of one integrated health care system (Kaiser Permanente Northern California); Geography: United States (Northern California); Life stage: Late preterm and term newborns, in the first 24 hours after birth for the calculator period; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Antibiotic administration in the first 24 hours (primary outcome); blood culture use, antibiotics from 24 to 72 hours, clinical outcomes and readmissions for early-onset sepsis (secondary). ### In a cohort of 204,485 infants born at 35 weeks or later at Kaiser Permanente Northern California hospitals from 2010 to 2015, care guided by a multivariable early-onset sepsis risk estimate combined with the infant's clinical condition in the first 24 hours (the EOS calculator period) was compared with an earlier baseline period that followed national recommended guidelines. Blood culture use fell from 14.5% to 4.9% (adjusted difference -7.7%; 95% CI -13.1% to -2.4%) and empirical antibiotic use in the first 24 hours fell from 5.0% to 2.6% (adjusted difference -1.8; 95% CI -2.4% to -1.3%). Antibiotic use between 24 and 72 hours did not increase (0.5% to 0.4%). Culture-confirmed early-onset sepsis was 0.03% in the baseline period, 0.03% in the learning period and 0.02% in the calculator period. Readmissions for early-onset sepsis within 7 days did not differ statistically (P = .70), and adverse clinical outcomes, including inotrope use, mechanical ventilation, meningitis and death, were unchanged. The authors conclude that the algorithms reduced testing and empirical antibiotics without apparent adverse effects. - Category: Effect - Evidence stage: Observational - Certainty: Certainty not assessed - Applies to: Recipient: Newborn; Population: 204,485 infants born at 35 weeks' gestation or later at Kaiser Permanente Northern California hospitals between January 1, 2010, and December 31, 2015. The models estimate sepsis risk among late preterm and term infants from objective data available at birth and the newborn's clinical status. The abstract does not apply them to infants born before 35 weeks.; Care setting: Hospitals of one integrated health care system (Kaiser Permanente Northern California); Geography: United States (Northern California); Life stage: Late preterm and term newborns, in the first 24 hours after birth for the calculator period; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Antibiotic administration in the first 24 hours (primary outcome); blood culture use, antibiotics from 24 to 72 hours, clinical outcomes and readmissions for early-onset sepsis (secondary). - Limitations: Only the abstract was read. It compares successive periods in one health system, not randomised groups, so other changes over time could contribute. It covers infants born at 35 weeks or later only. A 2024 update to the calculator was published in the journal Pediatrics; that article is an identity-only source in this atlas, so nothing from it is recorded and the figures here are those of the 2017 paper. - Last checked: 2026-10-15 - Sources: 1. Supports: A Quantitative, Risk-Based Approach to the Management of Neonatal Early-Onset Sepsis (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS sentences 2 to 7 and CONCLUSIONS AND RELEVANCE. Retrieved 2026-10-15T13:49:25Z. Source state: Current. Snapshot hash: 32f5da887042769e27a99cb2701ee7d62ad2ad500f61142507f6c098c89acc4e. How it applies: Testing, antibiotic use, incidence, readmissions and clinical outcomes. 2. Background: A Quantitative, Risk-Based Approach to the Management of Neonatal Early-Onset Sepsis (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, IMPORTANCE, DESIGN and MAIN OUTCOMES. Retrieved 2026-10-15T13:49:25Z. Source state: Current. Snapshot hash: 32f5da887042769e27a99cb2701ee7d62ad2ad500f61142507f6c098c89acc4e. How it applies: The models, cohort, periods and outcomes. ## Connected pages - Risk calculator for early-onset newborn sepsis: Early-onset newborn sepsis (`maternal:early-onset-neonatal-sepsis`) ## Provenance Content hash: e60a8bb29f20fc50be05f7e41b9d581a42c73c75366d2169ffacd0905808cfc5 Last substantive edit: 2026-10-15 Evidence last checked: 2026-10-15