LAUSR

Aim An audit of compliance with NICE guideline CG149 for the management of early onset neonatal sepsis (EONS) undertaken at this hospital indicated underperformance with respect to duration of antibiotic treatment and choice of benzylpenicillin dose. A re-audit was carried out to evaluate the impact of measures introduced to improve compliance, with a particular focus on duration of antibiotic treatment. Method Results of the initial audit were presented to the department, leading to the selection of champions for change. An intervention strategy was devised, which comprised of introducing a new section to the neonatal handover list, whereby date and time when repeat CRP and review of blood cultures should take place was clearly documented, together with results as they became available. This intervention was introduced at a departmental meeting, and received enthusiasm from junior doctors and consultants. Both audits were retrospective, spanning 12 months and 5 months respectively. Data were retrieved from case notes and the Trust’s electronic laboratory management system. Results The findings presented in the table 1 show that; audits analysed >75% of the cases of suspected EONS; proportion of babies receiving ≤48 hours of antibiotics increased from 18.5% to 69%; proportion of babies receiving a full 7 day course of treatment increased from 35% to 82%; compliance with benzylpenicillin dosing increased to 100%. Abstract G134(P) Table 1 Original Audit (12 months ) Re-audit (5 months ) p* Babies tested for suspected EONS, n 204 106 Casenotes reviewed, n (%) 159 (78) 80 (75.5) 0.95 Babies without sepsis receiving≤48 hours of antibiotics,% 18.5 69 <0.0001 Babies with sepsis receiving 7 days of antibiotics,% 35 82 0.02 50 mg/kg dose of benzylpenicillin used for meningitis only,% 0 100 <0.0001 *Mann-Whitney test Conclusion Introducing a robust system for ensuring the timely review of CRP and blood culture results has improved overall compliance with NICE guidelines, and in particular, has significantly reduced the number of babies receiving inappropriate durations of antibiotic treatment.