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Hospitalization v outpatient treatment of young, febrile infants
Insights
Most febrile infants under two months admitted to the hospital were not admitted. This study found no direct morbidity in infants not hospitalized, suggesting a potential shift in admission policies for febrile infants.
Area of Science:
- Pediatrics
- Infectious Disease
- Neonatal Care
Background:
- Many medical centers admit all febrile infants younger than two months.
- This practice is based on an unwritten policy and lacks extensive study.
Purpose of the Study:
- To evaluate the admission rate of febrile infants under two months.
- To compare characteristics of admitted versus non-admitted infants.
- To assess outcomes for febrile infants managed as outpatients.
Main Methods:
- Retrospective chart review over a three-year period.
- Analysis of 303 encounters with febrile infants younger than two months.
- Comparison of demographic and clinical factors between admitted and non-admitted infants.
Main Results:
- 35% (106/303) of febrile infants were not admitted.
- Infants were more likely to be admitted if male, under 30 days old, and had a temperature >38.5°C.
- No significant morbidity directly related to non-hospitalization was observed in outpatients.
Conclusions:
- A significant proportion of febrile infants under two months can be safely managed as outpatients.
- Clinical factors like age and temperature can help guide admission decisions.
- The study supports re-evaluation of strict admission policies for febrile infants.
Abstract:
Our medical center has an unwritten policy of admitting all febrile infants younger than 2 months of age. We studied this practice during a three-year period to determine what proportion of the febrile infants who came to the outpatient department were admitted. The characteristics of the infants who were not admitted were compared with those who were. The timing of and the infant's status at a subsequent visit for those not admitted were also identified. One hundred six (35%) of 303 encounters with young, febrile infants did not result in admissions. An infant was more likely to be admitted if he was male, younger than 30 days of age, and febrile (greater than 38.5 degrees C). None of the infants who were followed up as outpatients suffered morbidity that could be directly related to their not having been hospitalized.