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New traffic light system guides evaluation of febrile children
Author(s) -
Le Doare Kirsty,
Sharland Mike
Publication year - 2013
Publication title -
prescriber
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.106
H-Index - 3
eISSN - 1931-2253
pISSN - 0959-6682
DOI - 10.1002/psb.1090
Subject(s) - citation , computer science , information retrieval , operations research , library science , world wide web , mathematics
It is vital that these children are identified and treated early, while sup - portive management of children with minor bacterial or viral infections is instigated in the community. The NICE 2007 guid - ance (CG47) of the management of feverish illness in children incorporated a traffic light system for assessing symptoms but the accuracy of the original system was questioned because a substantial proportion of serious bacterial infections, especially urinary tract infections, were mistriaged as low risk. 4,5 8 However, the estimates of severe bacterial infec - tions that inform the NICE 2013 guidelines are based on research that is over 30 years old, making the health economic analysis difficult to interpret in today's paediatric population. Overcoming barriers A welcome area of the new NICE 2013 guidance is the section on parental education in the management of fever. It encourages a rational stepwise approach to antipyretic therapy and advocates a move away from a reliance on fever reduction as an indicator of nonsevere illness. The recommendation is to use antipyretics to relieve the child's distress rather than to reduce fever alone. Conclusions While the NICE 2013 guidance is a definite step in the right direc - tion for the identification of serious bacterial infections in the under-fives, it is clear that there is still much to be done. First and foremost, the new traffic light system requires validation. Research is also needed to identify which children are at low risk of serious bacterial infections and can be safely managed in the home.