The efficacy of routine outpatient management without antibiotics of fever in selected infants.
A previous study produced a protocol for outpatient management of febrile infants (FIs) judged to be at low risk for serious bacterial illness (SBI).
This Philadelphia protocol demonstrated that 40% of FIs seen in the emergency department could be safely managed without antibiotics at home ; and it was established by the emergency department staff as the standard of care at our institution.
To determine 1) the actual practices of management of FIs 18 months after establishment of the Philadelphia protocol as the standard of care, and 2) the continued efficacy of noninvasive outpatient management of fever in FIs who, using the Philadelphia protocol, were identified as low risk for SBI.
Thirty-six-month consecutive cohort study.
Urban pediatric emergency department.
Four hundred twenty-two infants, 29 to 60 days of age, with rectal temperatures >=38.0°C. Interventions.
After a complete history taking, physical examination, and workup for SBI, infants were managed at the discretion of the attending physician in the emergency department.
Subsequently, those management practices were reviewed and compliance with the Philadelphia protocol was evaluated.
In addition, the overall efficacy and safety of that standard during 8 years of use was assessed.
Results, Of the 422 FIs enrolled, 101 (24%) were prospectively identified as low risk for SBI, and safe for management without antibiotics. (...)
Mots-clés Pascal : Fièvre, Nourrisson, Homme, Conduite à tenir, Protocole thérapeutique, Normalisation, Exploration clinique, Recommandation, Etude comparative, Pratique professionnelle, Efficacité traitement, Etats Unis, Amérique du Nord, Amérique
Mots-clés Pascal anglais : Fever, Infant, Human, Clinical management, Therapeutic protocol, Standardization, Clinical investigation, Recommendation, Comparative study, Professional practice, Treatment efficiency, United States, North America, America
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0190712
Code Inist : 002B30A05. Création : 16/11/1999.