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Immature/Total Granulocyte Ratio as a Guide for Antibiotic Treatment in Suspected Early Onset Sepsis in Surinamese Newborns



Objective: Measurement of immature granulocytes may be helpful in the management of early onset sepsis (EOS) in newborns in developing countries. We evaluate early negative prediction of automated measurement of a one-point measurement of immature-to-total-granulocyte (I/T) ratio in newborns with suspected EOS to help decisions on duration of antibiotic treatment.

Methods: A retrospective study was performed amongst newborns with a gestational age ≥34 weeks with suspected EOS in whom local protocol had been followed for start and duration of antibiotic treatment, and in whom granulocyte counts had been measured with a Sysmex XT 2000i automated hematology analyzer.

Results: I/T and I/T2 were significantly lower (p = 0.048 and p = 0.015, respectively) in newborns with favourable clinical course and in whom EOS was unlikely. In these newborns antibiotics were stopped 48–72 hours after start after which they all remained healthy.

Conclusion: Low I/T and I/T2 may help to increase the threshold to start empirical antibiotics or to guide safe stoppage of antibiotics after 48–72 hours. Ultimately, this may help to reduce the antibiotic burden in developing countries. 

20 Dec, 2017
e-Published: 22 Dec, 2017


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