In 2017, the French public health authority HAS published new guidelines for the management of newborns at risk of early bacterial neonatal infection. These guidelines were based on ante- and intrapartum risk factors and clinical monitoring. In January 2021, we implemented a new protocol based on these guidelines in our tertiary maternity unit. To assess the impact of the protocol implemented on neonates’ antibiotic prescriptions. An "old protocol" group comprising newborns hospitalized between July 1, 2020 and December 31, 2020, was compared to a "new protocol" group formed between January 14, 2021 and July 13, 2021. Data were collected on infectious risk factors, antibiotic prescriptions, and emergency room visits within 2 weeks for an infection or suspected infection. The "old protocol" population comprised 1565 children and the "new protocol" population 1513. Antibiotic therapy was prescribed for 29 newborns (1.85 %) in the old protocol group versus 15 (0.99 %) in the new one ( = 0.05). The median duration was 5 days and 2 days respectively ( = 0.08). With the new protocol, newborns in category B were about 20 times more likely ( = 0.01), and those in category C about 54 times more likely ( = 0.005) to have an infection than those classified in categories N or A. This study demonstrates that clinical monitoring criteria enable reduced use and duration of antibiotic therapy and are reliable.

中文翻译：

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早发性新生儿败血症：基于产前和产时危险因素以及临床监测的分类有效性

2017年，法国公共卫生当局发布了新的新生儿细菌感染早期管理指南。这些指南基于产前和产时危险因素以及临床监测。 2021 年 1 月，我们在三级产科病房实施了基于这些指南的新方案。评估实施方案对新生儿抗生素处方的影响。将由2020年7月1日至2020年12月31日期间住院的新生儿组成的“旧方案”组与2021年1月14日至2021年7月13日期间形成的“新方案”组进行比较。收集了关于感染危险因素、抗生素等方面的数据。处方，并在 2 周内因感染或疑似感染而前往急诊室就诊。 “旧方案”人群包括 1565 名儿童，“新方案”人群包括 1513 名儿童。旧方案组中有 29 名新生儿 (1.85%) 接受了抗生素治疗，而新方案组 (= 0.05) 中有 15 名新生儿 (0.99%) 接受了抗生素治疗。中位持续时间分别为 5 天和 2 天 (= 0.08)。根据新方案，B 类新生儿感染的可能性大约是 N 类或 A 类新生儿的 20 倍（= 0.01），C 类新生儿感染的可能性大约是 N 类或 A 类新生儿的 54 倍（= 0.005）。这项研究表明临床监测标准能够减少抗生素治疗的使用和持续时间，并且是可靠的。