To determine primary-care pediatricians'management of febrile infants and compare them with published practice guidelines.
Case scenarios were sent to 194 primary-care pediatricians in Utah, describing three febrile infants, ages 21 days, 60 days, and 20 months, corresponding to the three age groups : 0 to 28 days ; 29 to 90 days, and 91 days to 36 months for which the guidelines suggest different strategies.
Ninety-four pediatricians responded (response rate, 48%). Compliance with the guidelines was 39% for the 21 day old, 9.6% for the 60 day old, and 75% for the 20 month old.
No respondent followed the guidelines for all three infants.
Performance of tests to determine if an infant was low risk varied from 3%, for a stool white cell examination in a febrile 2 month old with diarrhea, to 75% for a complete blood count in a 20 month old with a temperature of 40oC.
Compliance did not differ between private and academic practitioners.
Those in practice less than 5 years (n=22) were more likely than those with more experience to follow the guidelines for the 21 day old but not the other two infants.
Primary-care pediatricians in Utah manage febrile infants with fewer laboratory tests and less hospitalization than recent practice guidelines developed by an expert panel of academic specialists suggest.
Mots-clés Pascal : Fièvre, Hyperthermie, Enfant, Homme, Nourrisson, Diagnostic, Traitement, Pratique professionnelle, Pédiatrie, Médecin, Utah, Etats Unis, Amérique du Nord, Amérique, Etude comparative, Recommandation
Mots-clés Pascal anglais : Fever, Hyperthermia, Child, Human, Infant, Diagnosis, Treatment, Professional practice, Pediatrics, Physician, Utah, United States, North America, America, Comparative study, Recommendation
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0333182
Code Inist : 002B01. Création : 01/03/1996.