ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Neonatology
Safety and effectiveness of the Kaiser Permanente Early-Onset Neonatal Sepsis Calculator (EOSCAL) in Qatar
Provisionally accepted
Anvar Paraparambil Vellamgot1*
Sajid Thyvilayil Salim1Khalil Salameh1Sudheer Babu Kurunthattilthazhe1Abdurahiman Elikkottil1,2Lina Habboub1Rajesh Pattuvalappil1Biny Elizabeth Joseph1- 1Hamad Medical Corporation, Doha, Qatar
- 2KIMS Alshifa Super Speciality Hospital, Perinthalmanna, India
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Introduction Early-onset neonatal sepsis is a significant cause of neonatal morbidity and mortality worldwide. Although sepsis rates are declining, neonatal antibiotic use remains high. The early-onset sepsis risk calculator, endorsed by the American Academy of Pediatrics, is one of three evidence-based methods for identifying at-risk babies. This study retrospectively compared the calculator to the existing categorical approach. Objectives: The primary objective was to compare the effectiveness of the calculator with the existing categorical approach in identifying sepsis cases within the first 12 hours of life. Secondary aims included describing the calculator's recommendations and identifying predictors of missed cases. Methods We retrospectively analyzed cases of early-onset sepsis in late-preterm and term infants born in Qatar between 2015 and 2022. We compared the calculator's predicted effectiveness to the current categorical approach. Results Among 179,147 live births, 157 cases were identified (0.88 per 1,000). Of 105 cases (≥34 weeks), the calculator recommended antibiotics at birth in 37.1% (95% CI: 27.8%–46.4%) compared to 52% (42.9%–62.0%) by the categorical approach (p < 0.01), missing 16 cases. By 12 hours, it identified 58.1% versus 72.5% by the categorical approach (p < 0.01), missing 15 cases. Overall, the calculator missed six more cases than the categorical approach. Conclusions The calculator identified fewer cases and delayed treatment in some neonates compared to current practice. It should be used cautiously, tailored to local risks and clinical context, with close postnatal monitoring. Additional local prospective studies are necessary to improve EOS management and reduce unnecessary antibiotic use.
Keywords: Stewardship, Newborn, Sepsis, sepsis-calculator, Safety
Received: 30 May 2025; Accepted: 27 Oct 2025.
Copyright: © 2025 Paraparambil Vellamgot, Thyvilayil Salim, Salameh, Kurunthattilthazhe, Elikkottil, Habboub, Pattuvalappil and Joseph. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Anvar Paraparambil Vellamgot, avellamgot@hamad.qa
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