NeoNotes Journal Club
Andrew B. Kairalla MD, Editor
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3. Eligibility for Early Discharge.
Ø Designates change or addition to 1996 CDC guidelines.
ü Designates reiteration of 1996 CDC guidelines.
Ø Healthy-appearing infants who are >38 weeks' gestation at delivery and whose mother received >4 hours of IAP before delivery may be discharged home as early as 24 hours after delivery. This assumes that other discharge criteria have been met and that a person able to comply fully with instructions for home observation will be present.
ü If all of these conditions are not met, the infant should remain in the hospital for at least 48 hours of observation and until criteria for discharge are achieved.
Suggested Discussion Point:
What about
the 10% of infants with early-onset GBS sepsis who become symptomatic after
24 hours? Are we not
putting them at increased risk by early discharge?
Comments:
This recommendation
will be very popular with hospitals and managed care companies.
It is based on the demonstrated effectiveness of IAP at preventing
early GBS disease, and data indicating that 90% of infants with GBS sepsis
will become symptomatic in the first 24 hours.
ABK.
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