PSBI

Optimizing Place of Treatment and Antibiotic Regimens for Young Infants Presenting with Signs of Possible Serious Bacterial Infection (PSBI) (From Manual of Operations for Data Management and Data Monitoring)

Description

The WHO IMCI (Integrated management of childhood illness) algorithm classifies neonates and young infants < 2 months old with clinically suspected sepsis as possible severe bacterial infection. WHO guidelines recommend that young infants with PSBI should be managed in a hospital with injectable antibiotics and supportive care. When referral to hospital is not feasible, the guidelines recommend the further classification of these young infants into those who are critically ill and those who have clinical severe infection. Those with clinical severe infection (CSI), if referral is not feasible, should be managed on an outpatient basis with injectable gentamicin for 2 or 7 days plus oral amoxicillin for 7 days

CSI or Clinically Severe Infection has two parts:- RCT 1: Optimising place of treatment for young infants presenting with any low mortality risk sign of possible serious bacterial infection. RCT 2: Optimising duration of hospitalisation for young infants presenting with any moderate mortality risk sign of possible serious bacterial infection (RCT = Randomised Controlled Trial)

List of Possible serious bacterial infection

Possible serious bacterial infection commonly known as PSBI is defined as the presence of any of the following clinical signs in young infants up to 2 months of age [2]:

RCT1 (Single Risk Sign) (part CSI)

  • Severe chest indrawing
  • High body temperature (38°Cor above)
  • Fast breathing (60 breaths per minute or more) in infants < 7 days

RCT2 (Any of the following)

  • Low body temperature (less than 35.5°C)
  • Not feeding well
  • Movement only when stimulated
  • Multiple Single Risk Sign (RCT1)
  • Any combination of RCT1 and RCT2

CI (Critical Illness)

  • Convulsions
  • Not able to feed at all
  • No movement on stimulation
  • Mutliple CI
  • Multiple CI or Multiple CSI or Any combination of CI and CSI (i.e RCT1/RCT2)