Prevention and Management of Infants With Suspected or Proven Neonatal Sepsis

• neonatal sepsis
• group B streptococcus
• prevention
• treatment

In 2010, the Centers for Disease Control and Prevention in collaboration with the American Academy of Family Physicians, American Academy of Pediatrics (AAP), American College of Nurse-Midwives, American College of Obstetricians and Gynecologists, and American Society for Microbiology published revised group B streptococcal (GBS) guidelines entitled “Prevention of perinatal group B streptococcal disease: revised guidelines from CDC 2010” in the Morbidity and Mortality Weekly Report (MMWR).¹ The recommendations were endorsed by all the collaborating organizations including AAP after review by the Committee on Infectious Diseases (COID) and the Committee on Fetus and Newborn (COFN) and after AAP Board approval. In the report, a revised algorithm for “Secondary prevention of early-onset group B streptococcal disease” was included. This algorithm represented the expert opinions of the technical working group (based on current literature available at that time). In 2011, the COID and the COFN published a policy statement in Pediatrics that was in agreement with the 2010 GBS guidelines and included the same algorithm.²

In the spring of 2012, the COFN published a clinical report containing management guidelines entitled “Management of neonates with suspected or proven early-onset neonatal sepsis.”³ The 2012 COFN document includes guidance on laboratory evaluations and treatment duration, which were not addressed in the 2010 GBS prevention guidelines. The algorithms at the end of the COFN report differed from those in the 2010 guidelines published in the MMWR.¹ The discordance in the algorithms prompted questions by the pediatric community as to which recommendations …

Address correspondence to Michael T. Brady, MD, 700 Children’s Dr, AB 7048, Columbus, OH 43205. E-mail: michael.brady{at}nationwidechildrens.org