Fever survey highlights significant variations in how infants aged ≤60 days are evaluated and underline the need for guidelines

Havatzelet Yarden-Bilavsky, Shai Ashkenazi, Jacob Amir, Yechiel Schlesinger, Efraim Bilavsky

Research output: Contribution to journalArticlepeer-review

Abstract

Aim To assess the common practices for evaluating and treating febrile infants aged ≤60 days in a nationwide survey. Methods Questionnaires were administrated to inpatient paediatric departments in all 25 hospitals in Israel. Results Of the 25 centres surveyed (100% response rate), only 36% had written protocols concerning the approach to young febrile infants. The existence of a written protocol was significantly associated with the level of medical centre (tertiary versus primary and secondary, p = 0.041) and with the number of local paediatric infectious disease specialists (p = 0.034). In 13 (52%) hospitals, a normal white blood cell count was defined as 5000-15 000 cells/mL and 20 (80%) centres use C-reactive protein. Hospitalisation was mandatory in most (96%) centres for all neonates aged ≤28 days. Low-risk infants aged 29-60 days were hospitalised in 68.4% of the primary and secondary hospitals, compared with 33.3% tertiary centres. Ampicillin and gentamicin was the routine empiric antibiotic treatment for febrile infant in 92% of centres. Conclusion Significant differences exist among centres in the evaluation of febrile infants aged ≤60 days exist. These differences reflect the lack of, and highlight the need for, national or international guidelines for the evaluation of fever in this age group.

Original languageEnglish
Pages (from-to)379-385
Number of pages7
JournalActa Paediatrica, International Journal of Paediatrics
Volume103
Issue number4
DOIs
StatePublished - Apr 2014

Keywords

  • Bacteremia
  • National survey
  • Neonatal fever
  • Rochester criteria
  • Sepsis work-up
  • Serious bacterial infection
  • Urinary tract infection

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