Using the Rochester criteria to evaluate infantile fever is more effective in males than females

Miri Dotan*, Liat Ashkenazi-Hoffnung, Havazelet Yarden-Bilavsky, Jacob Amir, Naama Tirosh, Meirav Mor, Efraim Bilavsky

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Aim: The reliability of low-risk and high-risk criteria in evaluating febrile infants aged up to 60 days has been well documented. The aim of this study was to evaluate gender differences in the reliability of these criteria in order to exclude serious bacterial infection (SBI) in febrile infants. Methods: This study used the Rochester risk criteria, the study group was divided into low- or high-risk status for SBI, and the data were stratified by gender. SBI was defined as a urinary tract infection, bacteraemia, meningitis or bacterial enteritis. Results: We enrolled 1896 infants (58.3% males), and SBIs were found in 10.6% of the males and 8% of the females (p = 0.21). The sensitivity of the risk criteria was 91.5% for the males and 73.4% (p < 0.05) for the females, and the positive likelihood ratio was 2.64 in the males versus 2.14 in the females (p < 0.001). A multivariable analysis showed that high-risk male patients were more than two times more likely to develop a bacterial infection than high-risk females. Conclusion: The Rochester risk criteria had a significantly higher sensitivity and positive likelihood ratio in males. Our findings suggest that clinicians should take gender into account when evaluating febrile infants.

Original languageEnglish
Pages (from-to)e356-e359
JournalActa Paediatrica, International Journal of Paediatrics
Issue number8
StatePublished - 1 Aug 2016


  • Bacteraemia
  • Neonatal fever
  • Rochester criteria
  • Sepsis work-up
  • Serious bacterial infection


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