BACKGROUND<p style="text-align: justify;" data-mce-style="text-align: justify;">Many neonates are started on antibiotics even if they are well-appearing due to presence of risk factors. The Early Onset Sepsis (EOS) calculator is a web-based tool that calculates for composite risk scores for sepsis and limits empiric antibiotic therapy only as necessary.p>OBJECTIVE<p style="text-align: justify;" data-mce-style="text-align: justify;">This study aims to determine if there is a significant difference between the proportion of neonates recommended for antibiotics using the EOS calculator and AAP guidelines for neonatal sepsis.p>METHODS<p style="text-align: justify;" data-mce-style="text-align: justify;">This is a retrospective hospital-based cohort study where review of charts of neonates ≥34 weeks age of gestation (AOG) who were started on intravenous antibiotics within 72 hours of life for the period of 2019 to 2023 was done. Peripartum risk factors were used to calculate for EOS risk score and categorize those to be recommended for treatment using the score as well as the AAP guidelines. Newborns with growth on blood culture were identified. McNemar’s test was used to determine if there is a significant difference between the two proportions. Sensitivity and specificity of both tools were calculated.p>RESULTS<p style="text-align: justify;" data-mce-style="text-align: justify;">Out of 916 neonates, 345 (38%) and 469 newborns (51%) were advised empiric antibiotic therapy by the EOS calculator and AAP 2018 guidelines respectively. A McNemar Test revealed a significantly lower proportion of neonates recommended for antibiotic treatment using the EOS calculator (p < 0.001). Blood culture was taken from 208 newborns and six had positive isolates. Both the EOS calculator and AAP guidelines had 100% sensitivity and recommended antibiotics for these culture-proven sepsis cases. EOS calculator had a higher specificity (45% vs 32%).p>CONCLUSION<p style="text-align: justify;" data-mce-style="text-align: justify;">The EOS calculator as a risk assessment tool could significantly reduce use of antibiotics. The proportion of those who were recommended for antibiotics using the EOS calculator was significantly lower by 13% (p value =
Sepsis ; Infant, Newborn

Background: Retinopathy of prematurity (ROP) screening is uncomfortable and even painful in preterm infants. Objective: To determine the effectiveness of the Reverse-Kangaroo Mother Care (R-KMC) position compared with the conventional position in decreasing adverse physiological events and pain during ROP screening. Methods: This was a parallel randomized controlled trial with two arms- R-KMC position and conventional position (control). The primary outcomes included increased oxygen saturation, decreased heart and respiratory rates, and decreased pain intensity measured by Prematurity Infant Pain Profile (PIPP). Results: There were 100 preterm infants recruited. There were no differences in baseline characteristics, mean ROP screening duration, mean physiological parameters after the mydriatic application and during ROP screening between the two. Only the mean respiratory rates were significantly lower among the R-KMC group during the application of mydriatric agent. (50.26 ± 6.18 vs. 51.6 ± 8.35; p=0.0191). Relative risk (RR) in the control group is 37 to 84 versus 40 to 68 in the R-KMC group. The R-KMC group had a significantly lower mean PIPP score (6.5±2.06 vs. 8.8±2.80; p<0.0001) after mydriatic application and during ROP screening (7.6±2.05 vs. 9.8±2.90; p<0.0001) compared with control. No apnea was observed after mydriatic application, but one apneic episode was in control during ROP screening. 26% of the ROP screeners recommended the R-KMC position during ROP screening, while a majority (70%) was neutral. Conclusion R-KMC position, a low-cost intervention, significantly reduces pain during ROP screening. It is recommended as a position of choice during ROP screening.
Kangaroo-Mother Care Method