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Fever survey highlights significant variations in how infants aged ≤60 days are evaluated and underline the need for guidelines
Author(s) -
YardenBilavsky Havatzelet,
Ashkenazi Shai,
Amir Jacob,
Schlesinger Yechiel,
Bilavsky Efraim
Publication year - 2014
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12560
Subject(s) - medicine , pediatrics , ampicillin , white blood cell , gentamicin , antibiotics , emergency medicine , microbiology and biotechnology , biology
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 I srael. 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.