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Practice patterns of pediatric emergency medicine physicians caring for young febrile infants

Catherine C Ferguson1, Genie Roosevelt, Lalit Bajaj

  • 1Department of Pediatrics, The Children's Hospital, The University of Colorado Health Sciences Center, Aurora, 80045, USA. ferguson.catherine@tchden.org

Clinical Pediatrics
|July 1, 2009
PubMed

Insights

Physicians evaluated febrile infants aged 28-90 days. Older infants (60-90 days) received fewer diagnostic tests than younger ones, indicating poor adherence to clinical guidelines for febrile infant evaluation.

Area of Science:

  • Pediatrics
  • Emergency Medicine
  • Infectious Disease

Background:

  • Febrile infants aged 28-90 days require careful evaluation for serious bacterial infections.
  • Current guidelines exist for the diagnostic workup of these young patients.

Purpose of the Study:

  • To describe practice patterns in pediatric emergency departments for febrile infants (28-90 days).
  • To determine if evaluation and management differ based on infant age (28-59 days vs. 60-90 days).

Main Methods:

  • Retrospective chart review of febrile infants aged 28-90 days.
  • Comparison of diagnostic testing between two age groups: 28-59 days and 60-90 days.

Main Results:

  • Infants aged 60-90 days had significantly fewer complete blood cell counts, blood cultures, urine cultures, and cerebrospinal fluid cultures compared to infants aged 28-59 days.
  • Relative risks for fewer tests ranged from 2.56 to 3.83.
  • Overall adherence to diagnostic guidelines was poor.

Conclusions:

  • Physician practice patterns vary for febrile infants based on age.
  • There is a notable underutilization of recommended diagnostic tests in older infants (60-90 days).
  • Improved adherence to established guidelines is necessary for optimal febrile infant care.

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