Relationship of temperature pattern and serious bacterial infections in infants 4 to 8 weeks old 24 to 48 hours after antibiotic treatment
✍ Scribed by William A Bonadio; Mary Lehrmann; Halim Hennes; Douglas Smith; Ronald Ruffing; Marlene Melzer-Lange; Patricia Lye; Daniel Isaacman
- Publisher
- Elsevier Science
- Year
- 1991
- Tongue
- English
- Weight
- 240 KB
- Volume
- 20
- Category
- Article
- ISSN
- 1097-6760
No coin nor oath required. For personal study only.
✦ Synopsis
A new management approach to selected febrile infants 4 to 8 weeks old evaluated for possible sepsis is outpatient ceftriaxone therapy, w~th subsequent re-evaluation 24 to 48 hours after presentation. This study assessed whether the temperature profile of such infants during the 24-to 48-hour period after treatment distinguished those with from those without serious bacterial infections (SBIs).
Design: Prospective, descriptive clinical study.
Participants: One hundred sixty-one febrile infants 4 to 8 weeks old.
Setting: An urban pediatric emergency department and hospital.
Measurements and main results: All infants underwent a sepsis evaluation (lumbar puncture, CBC/blood culture, and urinalysis~urine culture) and were hospitalized for at least 48 hours. Temperatures were measured on presentation and then every four hours during hospitalization. All im fants received parenteral third-generation cephalosporin antibiotic therapy, and none received antipyretic medication unless fever was documented.. Fever (rectal temperature of more than 38.0 C) was documented during the 24-to 48-hour period after presentation in 28 infants (17.6%) -one of a total of 18 infants (5.6%) with SBI and 27 of a total of 143 infants (19%) without SBI (% more than .2; power, .30). All bacterial isolates in cases of SBI were susceptible to third-generation cephalosporin antibiotics. All re d peat blood and urine cultures that were performed in infants with bacteremia or urinary tract infections, respectively, were negative 24 hours after presentation.
Conclusion: Infants 4 to 8 weeks old who remain febrile during the 24 to 48-hour period after presentation and initiation of parenterai antibiotic therapy are less likely to have SBI. This study did not have sufficient power for this difference to be statistically significant.