A new clinical practice guideline issued by the American Academy of Pediatrics addresses questions related to evaluating otherwise well-appearing infants between 8-60 days old who develop a fever. The guideline breaks down recommendations for evaluation and care, and ranks the quality of available evidence. Risks and benefits also are detailed, including those concerning invasive procedures such as a lumbar puncture or bladder catheterization. Algorithms summarize recommendations for infants 8 to 21 days of age, 22 to 28 days of age, and 29 to 60 days of age.
“This febrile infant guideline represents a long journey towards a degree of careful flexibility, striving to balance benefits and harms,” said Charles R. Woods, MD, MS, an author of the guideline, chair of the Department of Pediatrics at the University of Tennessee College of Medicine- Chattanooga, and chief executive officer of Children’s Hospital at Erlanger in Chattanooga. “I have tremendous respect for everyone involved in its development and for their efforts to seek the best for our youngest. Like many guidelines, it will be improved upon over time, and the questions and data gaps identified on this journey create a roadmap for future research that will generate this improvement.”