Publications by authors named "K M Puopolo"

Objectives: To compare incidence of late-onset sepsis (LOS) among extremely preterm infants before and during the COVID-19 pandemic.

Methods: Multicenter cohort study of infants with birthweight 401 to 1000 g or gestational age 22 to 28 weeks. LOS was defined as a bacterial or fungal pathogen isolated from blood or cerebrospinal fluid culture obtained after 72 hours of age.

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We identified cord blood gentamicin concentrations that were higher than anticipated, and above clinical targets for immediate gentamicin re-dosing after birth. Incorporation of gentamicin levels at birth may aid in optimizing postnatal gentamicin dosing among infants exposed to intrapartum gentamicin.

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Anaerobe-targeted antibiotic (ATA) therapy may adversely impact the developing neonatal microbiome. We describe utilization patterns, potential indications, and related outcomes of ATA therapy in neonatal intensive care units across the United States over 13 years. While overall antibiotic use decreased, ATA use was unchanged.

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Background And Objectives: The Kaiser Permanente Neonatal Early-Onset Sepsis (EOS) Calculator has been an effective tool for risk stratification to safely reduce newborn antibiotic exposure. The calculator was derived from data on infants born between 1993 and 2007. Since that time, US obstetric practice has adopted universal antepartum screening for group B Streptococcus and intrapartum antibiotic prophylaxis guidance has changed.

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