Infants born at all gestational ages with low-risk delivery characteristics have a low risk for early-onset sepsis (EOS) and may not require initiation of empiric antibiotic therapy immediately following birth, according to a study published in Pediatrics. Dustin D. Flannery, DO, MSCE, and colleagues conducted a study involving term and preterm infants born from January 1, 2009, to December 31, 2014, with blood cultures and with or without cerebrospinal fluid cultures obtained 72 hours or less after birth and used delivery characteristics to identify those at lowest risk for EOS. The criteria for ascertaining low risk for EOS included cesarean delivery, without labor or membrane rupture before delivery, and no antepartum concern for intra-amniotic infection or nonreassuring fetal status. Among 7,549 infants evaluated, 41 had EOS. Of the evaluated infants, 14.8% had low-risk delivery characteristics, none of whom had EOS. Antibiotics were initiated in a lower proportion of these infants (80.4% vs 91.0%); however, there was no difference in the duration of antibiotics administered to infants born with and without low-risk characteristics.

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