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Duration of fever and serious bacterial infections in children: a systematic review

Gijs Elshout1, Miriam Monteny, Johannes C van der Wouden

  • 1Erasmus MC, Department of General Practice, PO Box 2040, 3000 CA Rotterdam, The Netherlands. g.elshout@erasmusmc.nl

BMC Family Practice
|May 18, 2011
PubMed

Insights

The link between longer fever duration and serious bacterial infections (SBI) in children is unclear. More research is needed, especially in primary care settings, to determine fever

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Epidemiology

Background:

  • Parents of febrile children frequently seek primary care.
  • Prolonged fever duration is a potential indicator for serious bacterial infections (SBI), but this association is debated.
  • Accurate prediction of SBI in febrile children is crucial for timely intervention.

Purpose of the Study:

  • To evaluate the predictive value of fever duration for identifying serious bacterial infections (SBI) in children.
  • To synthesize existing evidence on the association between fever duration and SBI risk.
  • To identify research gaps regarding fever duration as an SBI predictor in primary care.

Main Methods:

  • Systematic literature search of MEDLINE, Embase, and Cochrane databases (1991-2009).
  • Inclusion of studies on children aged 2 months to 6 years in high Haemophilus influenzae type b vaccination coverage areas.
  • Analysis focused on studies where fever duration was assessed as a predictor for serious bacterial infections.

Main Results:

  • Seven studies investigated the association between fever duration and SBI.
  • Three of the seven studies reported a significant relationship between longer fever duration and increased SBI risk.
  • No studies included in the review were conducted in a primary care setting.

Conclusions:

  • The predictive value of fever duration for diagnosing SBI in children remains inconclusive.
  • Current evidence is insufficient to reliably use fever duration to identify children with SBI.
  • Further research is essential, particularly studies conducted within primary care settings, to clarify the role of fever duration in predicting SBI.
Abstract

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