Related Experiment Video

Updated: Jan 18, 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

7.2K

Performance of AAP CPG for Ineligible Well-Appearing Febrile Infants Aged 8-60 Days

Melissa J Knudson1, Jeffrey P Yaeger1,2

  • 1Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York.

Hospital Pediatrics
|November 22, 2024
PubMed

Insights

A significant portion of febrile infants are ineligible for clinical guidelines. The study found that guideline-based approaches maintain high sensitivity in detecting invasive bacterial infections (IBIs) for all infants.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Clinical Practice Guidelines

Background:

  • The American Academy of Pediatrics (AAP) Clinical Practice Guidelines (CPG) offer guidance for evaluating well-appearing febrile infants aged 8-60 days for invasive bacterial infections (IBIs).
  • Limited guidance exists for febrile infants ineligible for the CPG, representing a potential gap in care.
  • This study addresses the need to understand the characteristics and IBI detection rates within this CPG-ineligible group.

Purpose of the Study:

  • To determine the proportion of well-appearing febrile infants who are ineligible for the AAP CPG.
  • To evaluate the performance of CPG-based strategies in identifying IBIs among CPG-ineligible infants.
  • To compare the diagnostic accuracy of CPG-based approaches in both eligible and ineligible infant cohorts.

Main Methods:

  • A secondary analysis of single-site data from 2011-2018 included well-appearing infants aged 8-60 days.
  • Infants were stratified by IBI risk using age and CPG inflammatory markers (temperature, absolute neutrophil count, C-reactive protein).
  • Receiver operating characteristic curves, sensitivity, and specificity were calculated for CPG-ineligible and CPG-eligible infants.

Main Results:

  • Out of 648 infants, 22% were CPG-ineligible.
  • Both CPG-ineligible and CPG-eligible groups achieved 100% sensitivity in detecting IBIs.
  • Specificities were comparable: 38.1% for CPG-ineligible and 38.2% for CPG-eligible infants.

Conclusions:

  • A substantial number of febrile infants do not meet CPG eligibility criteria.
  • CPG-based evaluation methods demonstrate high sensitivity for detecting IBIs in all infants, including those ineligible for the guidelines.
  • Further research is recommended to explore the impact of specific factors, such as preterm birth, on IBI risk in this population.
Abstract

More Related Videos

Author Spotlight: Assessing the Feasibility of Using Amplitude-Integrated EEG During Neonatal Transport05:15

Author Spotlight: Assessing the Feasibility of Using Amplitude-Integrated EEG During Neonatal Transport

Published on: June 21, 2024

1.2K
Guidelines for Elective Pediatric Fiberoptic Intubation11:19

Guidelines for Elective Pediatric Fiberoptic Intubation

Published on: January 17, 2011

18.4K

Related Concept Videos

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...
214
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...
257
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:
1.2K
Assessment of apical pulse01:17

Assessment of apical pulse

Assessing the Apical Pulse
Assessing the apical pulse is a critical nursing procedure, particularly indicated for:
2.0K
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...
1.0K
Standards of Care II01:19

Standards of Care II

Nurses bear specific legal responsibilities under several federal statutes, including:
1.0K