<p><strong>OBJECTIVES: </strong>Determine the prevalence of glucose concentrations below the Pediatric Endocrine Society (PES) term and late preterm-focused guideline target for mean glucose concentrations (≥70 mg/dL) among preterm NICU infants on full enteral nutrition and assess the impact on monitoring practices.</p>

<p><strong>STUDY DESIGN: </strong>Retrospective cohort study.</p>

<p><strong>RESULTS: </strong>We analyzed 1717 infants who were at least 2 days old and 48 hours after parenteral fluids were discontinued. Glucose concentrations were ≥70, 60-69, 50-59, and &lt;50 mg/dL in 76.6, 16.2, 5.9, and 1.3% of measurements, respectively. In multivariate models, concentrations &lt;60 mg/dL were common among male infants at lower postnatal age, small-for-gestational age, and born to women with hypertension (p &lt; 0.05). After PES guideline, infants were more likely to have &gt;3 glucose measurements (p &lt; 0.05).</p>

<p><strong>CONCLUSIONS: </strong>Glucose concentrations &lt;70 mg/dL are not uncommon among preterm infants receiving full enteral nutrition. Monitoring increased after guideline publication. Applying PES threshold to well-appearing preterm infants may promote increased monitoring and intervention without clear long-term benefit.</p>

<p><strong>OBJECTIVES: </strong>To quantify differences in early-onset sepsis (EOS) evaluations, evaluation-associated resource utilization, and EOS cases detected, when comparing time periods before and after the implementation of an EOS algorithm based on the Centers for Disease Control and Prevention (CDC) 2010 guidelines for prevention of perinatal Group B Streptococcus (GBS) disease.</p>

<p><strong>METHODS: </strong>Retrospective cohort study of infants born at ≥36 weeks' gestation from 2009 to 2012 in a single tertiary care center. One 12-month period during which EOS evaluations were based on the CDC 2002 guideline was compared with a second 12-month period during which EOS evaluations were based on the CDC 2010 guideline. A cost minimization analysis was performed to determine the EOS evaluation-associated costs and resources during each time period.</p>

<p><strong>RESULTS: </strong>During the study periods, among well-appearing infants ≥36 weeks' gestation, EOS evaluations for inadequate GBS prophylaxis decreased from 32/1000 to &lt;1/1000 live births; EOS evaluation-associated costs decreased by $6994 per 1000 live births; and EOS evaluation-associated work hours decreased by 29 per 1000 live births. We found no increase in EOS evaluations for other indications, total NICU admissions, frequency of infants evaluated for symptoms before hospital discharge, or incidence of EOS during the 2 study periods.</p>

<p><strong>CONCLUSIONS: </strong>Implementation of an EOS algorithm based on CDC 2010 GBS guidelines resulted in a 25% decrease in EOS evaluations performed among well-appearing infants ≥36 weeks' gestation, attributable to decreased evaluation of infants born in the setting of inadequate indicated GBS prophylaxis. This resulted in significant changes in EOS evaluation-associated resource expenditures.</p>