Related Experiment Video

Updated: Nov 25, 2025

A Controlled Mouse Model for Neonatal Polymicrobial Sepsis
14:54

A Controlled Mouse Model for Neonatal Polymicrobial Sepsis

Published on: January 27, 2019

11.5K

Roseville Protocol for the Management of Febrile Infants 7-60 Days

Tran H P Nguyen1, Beverly R Young2, Laura E Poggel2

  • 1Department of Hospital Pediatrics, Kaiser Permanente Northern California, Roseville, California; tran.h.nguyen@kp.org.

Hospital Pediatrics
|December 18, 2020
PubMed

Insights

The Roseville Protocol offers comparable accuracy to other methods for detecting invasive bacterial infection (IBI) in febrile infants. It reduces invasive procedures and hospitalizations for infants aged 29-60 days.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Febrile infants require careful evaluation for invasive bacterial infection (IBI).
  • Existing protocols like Rochester, Philadelphia, and Boston guide the management of fever in infants.
  • The Roseville Protocol is a modification of the Rochester Protocol with updated criteria.

Purpose of the Study:

  • To define the test characteristics of the Roseville Protocol for detecting IBI in febrile infants aged 7 to 60 days.
  • To retrospectively compare the performance of the Roseville Protocol against the Rochester, Philadelphia, and Boston protocols.
  • To evaluate the impact of the Roseville Protocol on lumbar puncture (LP) rates, admissions, and antibiotic use.

Main Methods:

  • Retrospective study of infants aged 7 to 60 days with fever from 2007 to 2016.
  • Application of four protocols (Roseville, Rochester, Philadelphia, Boston) to a cohort of 1803 infants.
  • Calculation of sensitivity, specificity, and comparison of recommended procedures (LPs, admissions, parenteral antibiotics).

Main Results:

  • For infants 7-28 days old, the Roseville Protocol showed 96.7% sensitivity and 99.5% negative predictive value, identifying 2 IBIs missed by the Rochester Protocol but increasing LPs and admissions by 19%.
  • For infants 29-60 days old, sensitivity was 91.4% and negative predictive value was 99.6%.
  • The Roseville Protocol significantly reduced LPs (18-100%) and admissions (18-51%) compared to other protocols in infants 29-60 days old.

Conclusions:

  • The Roseville Protocol demonstrates comparable sensitivity and specificity to existing protocols for IBI detection in febrile infants (7-60 days).
  • It offers a significant reduction in invasive procedures and hospitalizations for infants aged 29 to 60 days.
  • The protocol provides a viable alternative for managing febrile infants, balancing diagnostic accuracy with reduced intervention.
Abstract

More Related Videos

Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management06:43

Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management

Published on: November 21, 2017

24.7K
How to Administer Near-Infrared Spectroscopy in Critically ill Neonates, Infants, and Children07:27

How to Administer Near-Infrared Spectroscopy in Critically ill Neonates, Infants, and Children

Published on: August 19, 2020

12.1K

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:
1.0K
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...
6.1K
Pneumonia IV: Management01:28

Pneumonia IV: Management

The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
596
Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
306
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...
110
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
148