ASNS Expert Team Resources

General Information on Antibiotic Stewardship Programs

Core Elements of Hospital Antibiotic Stewardship Programs - Provides a thorough summary of core elements of a hospital based antibiotic stewardship program.  Also outlines key support staff, policies and interventions to improve antibiotic use,  suggestions for tracking and reporting antibiotic use, and includes a checklist for the core elements of a stewardship program.


Antibiotic Use in NICUs and Newborn Nurseries

Neonatal Intensive Care Unit Antibiotic Use - A review of antibiotic practice variation in 132 NICUs in California to include an examination of relationships with proven infection and other factors unambiguously connected with antibiotic exposure.

Antibiotic Stewardship:  Reassessment of Guidelines for Management of Neonatal Sepsis - A thorough review and comparison of the CDC and COFN guidelines to evaluate and manage neonatal sepsis.

Reappraisal of Guidelines of Management of Neonates with Suspected Early Onset Sepsis - A commentary on the case for moving beyond current recommendations for evaluation and treatment of term and late preterm infants for EOS.  The merits of the CDC and AAP guidelines for infants showing clinical signs of sepsis and for infants born under the maternal diagnosis of chorioamnionitis are debated.  The commentary concludes with eight suggested principles to guide innovation in managing suspected EOS.


Estimating the Probability of EOS

Estimating the Probability of Neonatal Early Onset Infection on the Basis of Maternal Risk Factors - Introducing of a predictive model for sepsis based on information available in the immediate perinatal period.  The model establishes a prior probability for newborn sepsis, which could be combined with neonatal physical examination and laboratory values to establish a posterior probability to guide treatment decisions.

The Conundrum of Early Onset Sepsis - A brief commentary on COFN recommendations and the introduction of the Kaiser sepsis calculator.  The commentary ends with six conclusions and three practice suggestions for managing infants with early onset sepsis.

Stratification of Risk of Early Onset Sepsis in Newborns Greater than or Equal to 34 Weeks Gestation - This article presents the risk stratification strategy that belies the Kaiser sepsis calculator.


Adverse Consequences of Antibiotic Use in Newborns

Adverse Consequences of Neonatal Antibiotic Exposure - A review and opinion paper covering current data regarding the rationale for empirical use of antibiotics, variations in prescribing practices, emerging resistance, and how antibiotics affect the microbiome of the neonate.  The review ends with a discussion of practice modifications and current stewardship efforts.