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Evaluation and Management of Well-Appearing Febrile Infants 8 to 60 Days Old

Robert H Pantell1, Kenneth B Roberts2, William G Adams3

  • 1Department of Pediatrics, School of Medicine, University of California San Francisco, San Francisco, California Robert.Pantell@UCSF.edu.

Pediatrics
|July 20, 2021
PubMed

Insights

This guideline provides evidence-based recommendations for evaluating and managing fever in well-appearing infants aged 8 to 60 days. It offers guidance on diagnostic testing and antimicrobial use to optimize infant care.

Area of Science:

  • Pediatrics
  • Infectious Disease Management

Background:

  • Fever in infants 8 to 60 days old requires careful evaluation.
  • Existing guidelines may not fully incorporate latest evidence or shared decision-making.

Purpose of the Study:

  • To provide evidence-based guidelines for the evaluation and management of fever in well-appearing, term infants (8-60 days).
  • To develop key action statements, including numbers needed to test and treat, and decision-making algorithms.

Main Methods:

  • Commissioned evidence-based review by the Agency for Healthcare Research and Quality.
  • Extensive literature review and analysis of supplemental data from peer-reviewed studies.
  • Assessment of evidence quality and benefit-harm for 21 key action statements.

Main Results:

  • Derived 21 key action statements with graded recommendations based on evidence quality and benefit-harm assessment.
  • Developed "numbers needed to test" for diagnostic testing and "numbers needed to treat" for antimicrobial administration.
  • Created three algorithms to guide management for specific infant age groups (8-21, 22-28, 29-60 days).

Conclusions:

  • Recommendations emphasize incorporating parental values and preferences into shared decision-making.
  • Guideline provides a framework for managing infant fever but allows for individualized care.
  • Algorithms aim to standardize and optimize the evaluation and treatment of febrile infants.

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