4.7 Article

Evaluation and Management of Well-Appearing Febrile Infants 8 to 60 Days Old

Journal

PEDIATRICS
Volume 148, Issue 2, Pages -

Publisher

AMER ACAD PEDIATRICS
DOI: 10.1542/peds.2021-052228

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This guideline provides recommendations for the evaluation and management of well-appearing term infants, 8 to 60 days of age, with fever >= 38.0 degrees C. It emphasizes the importance of incorporating parents' values and preferences into shared decision-making, and acknowledges the need for variations in treatment based on individual circumstances. The recommendations aim to guide diagnostic testing and antimicrobial administration, with numbers needed to test and treat provided.
This guideline addresses the evaluation and management of well-appearing, term infants, 8 to 60 days of age, with fever >= 38.0 degrees C. Exclusions are noted. After a commissioned evidence-based review by the Agency for Healthcare Research and Quality, an additional extensive and ongoing review of the literature, and supplemental data from published, peer-reviewed studies provided by active investigators, 21 key action statements were derived. For each key action statement, the quality of evidence and benefit-harm relationship were assessed and graded to determine the strength of recommendations. When appropriate, parents' values and preferences should be incorporated as part of shared decision-making. For diagnostic testing, the committee has attempted to develop numbers needed to test, and for antimicrobial administration, the committee provided numbers needed to treat. Three algorithms summarize the recommendations for infants 8 to 21 days of age, 22 to 28 days of age, and 29 to 60 days of age. The recommendations in this guideline do not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.

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