Table 8.8Evidence profile for composite measures in babies about to start antibiotic treatment

Number of studiesNumber of babiesSensitivity (95% confidence interval)Specificity (95% confidence interval)Positive likelihood ratio (95% confidence interval)Negative likelihood ratio (95% confidence interval)Quality
Composite measure based on CRP (> 10 mg/l) and/or PCT (≥0 .50 ng/ml) in the prediction of infection within 10 days of birth, using blood culture and/or clinical diagnosis of infection as reference standard
1 (Franz 1999)16263 (48 to 77)66 (57 to 74)20.6Moderate
Composite measure based on CRP (> 10 mg/l) and/or IL-8 (≥70 pg/ml) in the prediction of infection within the first 3 days of life, using blood culture or clinical infection as reference standard
1996/1997 data
1 (Franz 2001)37892 (82 to 97)74 (68 to 79)4 (3 to 4)0.2
(0.1 to 0.3)
High
1997/1998 data
1 (Franz 2001)33192 (85 to 96)77 (71 to 83)4 (3 to 5)0.1
(0.1 to 0.2)
High
Composite measure based on CRP (> 10 mg/l) and/or IL-8 (≥70 pg/ml) in the prediction of infection within 10 days of birth, using blood culture and/or clinical diagnosis of infection as reference standard
1 (Franz 1999)16291 (79 to 98)73 (64 to 81)30.1Moderate
Composite measure based on CRP (> 10 mg/l) and/or I:T ratio (> 0.2) in the prediction of infection within the first 3 days of life, using blood culture or clinical infection as reference standard
1996/1997 data
1 (Franz 2001)37891 (80 to 97)41 (35 to 47)2 (1 to 2)0.2
(0.1 to 0.5)
High
1997/1998 data
1 (Franz 2001)33173 (63 to 83)49 (41 to 58)1(1 to 2)0.6
(0.4 to 0.8)
High
Composite measure based on PCT (> 5.75 ng/ml) and IL-6 (> 12 pg/ml) at presentation in the prediction of infection within 72 hours of birth, using blood culture or clinical infection as reference standard
1
(Bender 2008)
123934620.2Low
Composite measure based on PCT (> 5.75 ng/ml) and IL-8 (> 130 pg/ml) at presentation in the prediction of infection within 72 hours of birth, using blood culture or clinical infection as reference standard
1
(Bender 2008)
123894420.3Low
Composite measure based on PCT (> 5.75 ng/ml) and IL-10 (> 15 pg/ml) at presentation in the prediction of infection within 72 hours of birth, using blood culture or clinical infection as reference standard
1
(Bender 2008)
123934820.2Low
Composite measure based on PCT (> 5.75 ng/ml) and I:T ratio (> 0.2) at presentation in the prediction of infection within 72 hours of birth, using blood culture or clinical infection as reference standard
1
(Bender 2008)
123856020.3Low
Composite measure based on Predictive score > 0.503 in the prediction of infection within first 72 hours of life, using clinical findings consistent with sepsis or positive cultures as reference standard Predictive score formula = (WBC × 0.01) + (I:T ratio × 5.7) − (I:M ratio × 2.9) + (CRP × 0.01)
1
(Selimovic 2010)
3417389NCNCVery low
Composite measure based on combination of prenatal maternal colonisation, prolonged rupture of membranes ≥ 12 hours, mechanical ventilation at birth, IL-6 concentration ≥ 300 pg/ml and IL-8 concentration ≥ 200 pg/ml with score ≥ 6.5 predicting infection, using clinical findings consistent with sepsis or positive cultures as reference standard
1
(Labenne 2011)
213100(86 – 100)80 (73 to85)5.5 (4.1 to 6.8)0Low

CRP C-reactive protein, IL interleukin, I:M ratio of immature to mature neutrophils, I:T ratio of immature to total neutrophils, NC not calculable, PCT procalcitonin

See the complete GRADE Table J 8.8

From: 8, Investigations before starting antibiotics in the baby

Cover of Antibiotics for Early-Onset Neonatal Infection
Antibiotics for Early-Onset Neonatal Infection: Antibiotics for the Prevention and Treatment of Early-Onset Neonatal Infection.
NICE Clinical Guidelines, No. 149.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2012 Aug.
Copyright © 2012, National Collaborating Centre for Women’s and Children’s Health.

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