Infection
Early-onset infection: risk factor checklist (NICE NG195, UK)
Tick the risk factors and clinical indicators from NICE NG195 to see what its framework says about investigating and starting antibiotics. The decision is made by a senior.
For education. Check against your unit's guidance and a second clinician before use.
Red flags
Risk factor and clinical indicators that NICE treats as red flags.
Other risk factors (before birth)
Other clinical indicators (in the baby)
- What the NICE framework says
- No risk factors or indicators ticked: NG195 advises routine postnatal care
- Red flags ticked
- 0
- Other risk factors and indicators ticked
- 0
This shows the NICE NG195 framework (recommendation 1.10.3) for education. The decision about this baby is made by the responsible senior clinician, with your unit's policy.
Some UK units use the Kaiser Permanente neonatal sepsis calculator instead for babies born after 34+0 weeks, as part of a prospective audit (NG195 1.10.4).
Outside the UK: in the USA, the AAP clinical reports (2018) describe three approaches for babies of 35 weeks or more (categorical risk factors, the Kaiser sepsis calculator, or enhanced observation) and a separate approach for more preterm babies; where resources are limited, WHO guidance on possible serious bacterial infection in young infants applies. Follow your national guidance.
How this is calculated
- Any red flag, or two or more other risk factors or clinical indicators: investigate and start antibiotics without waiting for results. One risk factor or indicator and no red flags: clinical judgement, with monitoring for at least 12 hours if needed. None: routine postnatal care.
Sources
- Puopolo KM, et al. Management of neonates born at 35 weeks' gestation or more with suspected or proven early-onset bacterial sepsis. Pediatrics 2018;142:e20182894.
- Kaiser Permanente neonatal early-onset sepsis calculator.
- NICE. Neonatal infection: antibiotics for prevention and treatment (NG195), risk factors and clinical indicators for early-onset infection (boxes 1 and 2, recommendation 1.10.3), as updated in 2026. Paraphrased; read the original.
Checked by NICUlearn, 6 Oct 2026.