Impact of a Hypothermic Young Infant Clinical Pathway: A Single Site Study

This study evaluated the impact of implementing a standardized institutional pathway on the evaluation and management of hypothermic infants, focusing on serious bacterial infection (SBI) workups, hospital admissions, antibiotic use, and re-admissions. We performed a single-institution subset study involving infants ≤60 days of age who presented to the emergency department or were hospitalized for hypothermia over a 5-year period before and after pathway implementation. Among 231 patients (157 pre- and 74 post-pathway), full SBI evaluations decreased from 61.1% to 48.5%, partial evaluations from 35.0% to 29.7%, and no evaluations increased from 3.8% to 21.6% (P < .001). Hospital admission rates dropped from 92.9% to 70.8% (P < .007), and antibiotic administration declined from 68.1% to 51.3% (P = .02). Re-admission rates were unchanged, and no SBI or IBI cases were missed. These findings suggest that a clinical pathway can safely reduce invasive evaluations, hospitalizations, and antibiotic use in this population.