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Clinical Guideline Synopsis of Evaluation and Management of Well-Appearing Febrile Infants Aged 8 to 60 Days

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Efforts to develop an evidence-based approach to the evaluation and management of young febrile infants have spanned decades. Nonadherence to previous clinical prediction models1 as well as changing bacteriology,2 cost of unnecessary care, advances in testing, and evolving research provided the impetus for this guideline.3,4

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Article Information

Corresponding Author: Eileen Murtagh Kurowski, MD, MS, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, MLC 2008 Cincinnati, OH 45229-3039 (eileen.murtagh-kurowski@cchmc.org).

Published Online: March 14, 2022. doi:10.1001/jamapediatrics.2022.0066

Conflict of Interest Disclosures: None reported.

References
1.
Aronson  PL , Thurm  C , Alpern  ER ,  et al; Febrile Young Infant Research Collaborative.  Variation in care of the febrile young infant <90 days in US pediatric emergency departments.   Pediatrics. 2014;134(4):667-677. doi:10.1542/peds.2014-1382PubMedGoogle ScholarCrossref
2.
Powell  EC , Mahajan  PV , Roosevelt  G ,  et al; Febrile Infant Working Group of the Pediatric Emergency Care Applied Research Network (PECARN).  Epidemiology of bacteremia in febrile infants aged 60 days and younger.   Ann Emerg Med. 2018;71(2):211-216. doi:10.1016/j.annemergmed.2017.07.488PubMedGoogle ScholarCrossref
3.
Gomez  B , Mintegi  S , Bressan  S , Da Dalt  L , Gervaix  A , Lacroix  L ; European Group for Validation of the Step-by-Step Approach.  Validation of the “step-by-step” approach in the management of young febrile infants.   Pediatrics. 2016;138(2):e20154381. doi:10.1542/peds.2015-4381PubMedGoogle ScholarCrossref
4.
Kuppermann  N , Dayan  PS , Levine  DA ,  et al; Febrile Infant Working Group of the Pediatric Emergency Care Applied Research Network (PECARN).  A clinical prediction rule to identify febrile infants 60 days and younger at low risk for serious bacterial infections.   JAMA Pediatr. 2019;173(4):342-351. doi:10.1001/jamapediatrics.2018.5501PubMedGoogle ScholarCrossref
5.
Hui  C , Neto  G , Tsertsvadze  A ,  et al.  Diagnosis and management of febrile infants (0-3 months).   Evid Rep Technol Assess (Full Rep). 2012;(205):1-297.PubMedGoogle Scholar
6.
Ladhani  SN , Henderson  KL , Muller-Pebody  B , Ramsay  ME , Riordan  A .  Risk of invasive bacterial infections by week of age in infants.   Arch Dis Child. 2019;104(9):874-878. doi:10.1136/archdischild-2018-316191PubMedGoogle ScholarCrossref
7.
Aronson  PL , Schaeffer  P , Niccolai  LM , Shapiro  ED , Fraenkel  L .  Parents’ perspectives on communication and shared decision making for febrile infants ≤60 days old.   Pediatr Emerg Care. 2021;37(12):e1213-e1219.PubMedGoogle ScholarCrossref
8.
Aronson  PL , Shabanova  V , Shapiro  ED ,  et al; Febrile Young Infant Research Collaborative.  A prediction model to identify febrile infants ≤60 days at low risk of invasive bacterial infection.   Pediatrics. 2019;144(1):e20183604. doi:10.1542/peds.2018-3604PubMedGoogle ScholarCrossref
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