Kaiser-Permanente Sepsis Risk Calculator (KP-SRC) has safely reduced antibiotic use in the management of early-onset neonatal sepsis (EONS) in the USA and has been endorsed by the American Academy of Pediatrics.1 However, the updated UK National Institute for Health and Care Excellence (NICE) guidance 2021 (NG195) is risk factor based. It does permit the use of KP-SRC, but only with prospective audit, due to reservations regarding its applicability and safety in the UK setting.2

A recent Welsh study demonstrated the effectiveness of KP-SRC; however, Birmingham has significant inherent population differences (higher socioeconomic deprivation, ethnic diversity, EONS incidence and perinatal mortality).3 We aimed to implement KP-SRC in our diverse high-risk population to evaluate its safety following our pre-implementation study.4

KP-SRC was applied to all babies born ≥34 weeks’ gestation, who would have received antibiotics as per the NICE guidance in three …