Neonatal early-onset sepsis calculator

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).

• Effect Observational Certainty not assessed

  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.

  Applies to Newborn

  • 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.
  • Hospitals of one integrated health care system (Kaiser Permanente Northern California)
  • United States (Northern California)
  • 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).

  Certainty method

  Not assessed

  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

  Next evidence check due

  Not scheduled

  Sources and citations (2)

  1. Supports A Quantitative, Risk-Based Approach to the Management of Neonatal Early-Onset Sepsis

     Publication · JAMA pediatrics · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2017-04-01 · DOI: 10.1001/jamapediatrics.2016.4678 · PMID: 28241253

     Locator

     Abstract, RESULTS sentences 2 to 7 and CONCLUSIONS AND RELEVANCE

     How it applies

     Testing, antibiotic use, incidence, readmissions and clinical outcomes.

     Retrieved

     2026-10-15T13:49:25Z

     Source effective date

     Not reported

     Source state

     Current

     Snapshot hash

     32f5da887042769e27a99cb2701ee7d62ad2ad500f61142507f6c098c89acc4e

     Reuse basis

     PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

  2. Background A Quantitative, Risk-Based Approach to the Management of Neonatal Early-Onset Sepsis

     Publication · JAMA pediatrics · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2017-04-01 · DOI: 10.1001/jamapediatrics.2016.4678 · PMID: 28241253

     Locator

     Abstract, IMPORTANCE, DESIGN and MAIN OUTCOMES

     How it applies

     The models, cohort, periods and outcomes.

     Retrieved

     2026-10-15T13:49:25Z

     Source effective date

     Not reported

     Source state

     Current

     Snapshot hash

     32f5da887042769e27a99cb2701ee7d62ad2ad500f61142507f6c098c89acc4e

     Reuse basis

     PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.