Related Experiment Video

Updated: Jun 21, 2026

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
11:27

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn

Published on: April 7, 2023

Practice variations in the treatment of febrile infants among pediatric emergency physicians

Ran D Goldman1, Dennis Scolnik, Laurel Chauvin-Kimoff

  • 1Division of Pediatric Emergency Medicine, Department of Pediatrics, British Columbia Children's Hospital, Vancouver, Canada. rgoldman@cw.bc.ca

Pediatrics
|July 22, 2009
PubMed

Insights

Treatment decisions for febrile infants varied significantly across Canadian pediatric emergency departments. Key diagnostic tests and antibiotic use differed between centers, highlighting practice variations.

Area of Science:

  • Pediatric Emergency Medicine
  • Infant Health
  • Clinical Practice Variation

Background:

  • Young infants with fever present a diagnostic challenge in emergency settings.
  • Standardized evaluation and treatment protocols are crucial for optimal care.

Purpose of the Study:

  • To characterize variations in treatment decisions for young febrile infants.
  • To document practice variations among pediatric emergency department practitioners in Canada.

Main Methods:

  • Prospective, concurrent cohort study of 257 infants (<90 days) with fever.
  • Data collected from 6 Canadian pediatric emergency departments.
  • Follow-up via telephone to confirm final disposition.

Main Results:

  • While patient demographics and fever characteristics were similar, diagnostic testing rates (lumbar puncture, respiratory virus testing, chest radiography) varied.
  • 55% of infants received antibiotics, with significant variations in antibiotic choice and quantity.
  • Differences noted in the incidence of cough and reported sick contacts across centers.

Conclusions:

  • Substantial practice variations exist in the evaluation and management of febrile infants in tertiary pediatric emergency departments.
  • While blood and urine tests were common, rates of cerebrospinal fluid testing and antibiotic administration differed significantly across centers.
Abstract

Related Concept Videos

Methods of reducing fever01:22

Methods of reducing fever

The signs and symptoms of fever include hot and dry skin, flushed face, thirst, muscle aches, anorexia, headache, tachycardia, tachypnea, and fatigue. Elevated body temperature is reduced using two methods: pharmacological and nonpharmacological. Proper identification and treatment of the root cause of a fever is of utmost importance.
Pharmacological Methods of Reducing Fever:
Patterns of Fever01:26

Patterns of Fever

Before understanding the types and patterns of fever, it is essential to know its phases.
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Decreased Body Temperature01:29

Decreased Body Temperature

A decreased body temperature can occur in patients with hypothermia and frostbite. Heat loss with extended cold exposure overpowers the body's ability to create heat, resulting in hypothermia. Core temperature readings help classify hypothermia. Mild hypothermia is temperatures between 32 °C (89.6 °F) and 35°C (95 °F) and is caused by impaired thermoregulation. Moderate hypothermia is temperatures between 28 C (82.4 °F) and 32 °C (89.6 °F) caused by sustained extreme cold exposure, and severe...
Increased Body Temperature01:25

Increased Body Temperature

A body temperature above  38°C  (100.4 °F) is known as fever or pyrexia, and a person with fever is termed 'febrile.' Typically, the hypothalamus, a part of the brain that acts as the body's thermostat, regulates body temperature through a thermoregulatory setpoint. It receives signals from cold and warm thermal receptors throughout the body and adjusts the body's temperature accordingly. Fever occurs when this hypothalamic setpoint is altered, usually in response to an infection or illness.