Home care for antibiotic therapy in the management of maternal-fetal infection: Action research example
Authors:   Service de Médecine et Réanimation Néonatales, Centre National de Néonatologie et Nutrition, Hôpital d’Enfants, Centre Hospitalier Ibn Sina, bd Ibn Rochd, Souissi 10100, Rabat, Morocco, Radouani MA. ,   Equipe de Recherche en Santé et Nutrition du Couple Mère Enfant, Faculté de Médecine et de Pharmacie de RabatUniversité Mohammed V, Morocco, Taboz Y. ,   Unité Mixte de Recherche en Nutrition et Alimentation URAC 39, Université Ibn to Fail-CNESTEN; RDC-Nutrition AFRA/AIEA, Kénitra, Morocco, Benkirane H. ,   Unité Mixte de Recherche en Nutrition et Alimentation URAC 39, Université Ibn to Fail-CNESTEN; RDC-Nutrition AFRA/AIEA, Kénitra, Morocco, Aguenaou H. ,   Unité Mixte de Recherche en Nutrition et Alimentation URAC 39, Université Ibn to Fail-CNESTEN; RDC-Nutrition AFRA/AIEA, Kénitra, Morocco, Barkat A. ,   Service de Médecine et Réanimation Néonatales, Centre National de Néonatologie et Nutrition, Hôpital d’Enfants, Centre Hospitalier Ibn Sina, bd Ibn Rochd, Souissi 10100, Rabat, Morocco,   Equipe de Recherche en Santé et Nutrition du Couple Mère Enfant, Faculté de Médecine et de Pharmacie de RabatUniversité Mohammed V, Morocco
Published: March 2022

Introduction- Given the progress in medical care in neonatology, the development of neonatal medicine evaluation techniques and management of difficulties in our Moroccan context, the need to increase the alternative structures for complete hospitalization (CH) in this discipline, is clear. Purpose- Assess the economic and neonatal outcomes of neonatal infection in case of further outpatient care. Material and methods- This is a prospective, single-center including newborns hospitalized for infection between 1 January 2011 and 31 December 2013. Exclusion criteria were respiratory distress, birth defects, direct admission neonatal resuscitation. Results- 1060 neonates were included. The parturients had a preterm rupture of membranes PRM in 70% of cases. We had found a tinted amniotic fluid in 23% of cases. Mothers had chorioamnionitis in 20% of cases. We noted the presence of vaginal discharge with vaginal itching in 18% of cases. of mictional burns were found in 10% of cases. Breast laboratory tests (urinalysis, vaginal swabs, blood cultures, CRP) was positive in 3% of cases the mean birth weight was 3300.20 grams +/- 600. The average age was +/- 1.4 days 0.45. Thirty percent of the children were exclusively breastfed. 80% of patients were asymptomatic at admission. The clinical signs were found mainly respiratory distress. Mean CRP was 35,12mg / L +/- 3.5. The average duration of the PRM was 9.66 +/- 57.7 hours. The examination at the end of treatment was without abnormalities in 89.2% of cases. CRP control was below 6 mg / l in 48% of cases. The evolution of life on day 28 was favorable in 100% of cases. The average length of hospital treatment was 2.87 +/- 1.145 days; the average duration of treatment as outpatients was 2.74 +/- 1.31 days. 100% of newborns received treatment by parenteral perfusion according the protocol of the center. The average number of hospital days per patient spared protocol averaged 3.21 +/- 0.78 days. The average amount saved per patient was 82.65 +/- 5.51 Euros. Total amount saved over three years was 83,000 Euros. Conclusion- The partial hospitalization seems possible for infected newborns without aggravating their illness. It also contributes significantly to the health economy.