The evaluation of diagnostic management in young febrile infants

  • Research type

    Research Study

  • Full title

    The evaluation of diagnostic management in young febrile infants at risk for serious infections

  • IRAS ID

    210282

  • Contact name

    Ian Maconochie

  • Contact email

    ian.maconochie@imperial.nhs.uk

  • Sponsor organisation

    Imperial College London and Imperial College Healthcare NHS Trust

  • Duration of Study in the UK

    4 years, 3 months, 31 days

  • Research summary

    Fever is a common presentation in the emergency department. It often appears in neonates as an innocent viral infection, but in 8,5%-12.8% of the neonates the infection develops as a serious bacterial infection(SBI). Distinguish febrile children with self limiting febrile illnesses or a SBI is hard, as they both present with similar non specific symptoms at an early stage. A SBI could have severe consequences if not treated appropriately. Therefore in 1980 it
    was recommended to admit and treat all febrile infants at risk with empiric antibiotics. As a result unnecessarily hospitalisation and prescribing medication were exposed to children with self-limiting illnesses. Unnecessary medication could cause adverse events and do harm to children.
    In the recent decades several prediction models and low-risk criteria have been developed to identify children at low risk for a serious bacterial infection. However, the low risk criteria should be used carefully, since they fail to rule out a SBI completely. Despite the developing of criteria and guidelines, there is still remarkable variety in managing the care of children with fever. There is extensive literature on fever in children, but is often out-dated and not focussed on this specific age group. Therefore more work is needed to manage infants with fever accurately at an early stage. This work will see if there are predictors that can help distinguish SBI from viral infection.

  • REC name

    London - Central Research Ethics Committee

  • REC reference

    16/LO/1522

  • Date of REC Opinion

    10 Aug 2016

  • REC opinion

    Favourable Opinion