Journal article
Guideline adherence in febrile children below 3 months visiting European emergency departments: an observational multicenter study
- Abstract:
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Febrile children below 3 months have a higher risk of serious bacterial infections, which often leads to extensive diagnostics and treatment. There is practice variation in management due to differences in guidelines and their usage and adherence. We aimed to assess whether management in febrile children below 3 months attending European Emergency Departments (EDs) was according to the guidelines for fever. This study is part of the MOFICHE study, which is an observational multicenter study including routine data of febrile children (0–18 years) attending twelve EDs in eight European countries. In febrile children below 3 months (excluding bronchiolitis), we analyzed actual management compared to the guidelines for fever. Ten EDs applied the (adapted) NICE guideline, and two EDs applied local guidelines. Management included diagnostic tests, antibiotic treatment, and admission. We included 913 children with a median age of 1.7 months (IQR 1.0–2.3). Management per ED varied as follows: use of diagnostic tests 14–83%, antibiotic treatment 23–54%, admission 34–86%. Adherence to the guideline was 43% (374/868) for blood cultures, 29% (144/491) for lumbar punctures, 55% (270/492) for antibiotic prescriptions, and 67% (573/859) for admission. Full adherence to these four management components occurred in 15% (132/868, range 0–38%), partial adherence occurred in 56% (484/868, range 35–77%).
Conclusion: There is large practice variation in management. The guideline adherence was limited, but highest for admission which implies a cautious approach. Future studies should focus on guideline revision including new biomarkers in order to optimize management in young febrile children.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Corrected version of record, pdf, 618.6KB, Terms of use)
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(Preview, Version of record, pdf, 917.5KB, Terms of use)
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- Publisher copy:
- 10.1007/s00431-022-04606-5
Authors
- Publisher:
- Springer
- Journal:
- European Journal of Pediatrics More from this journal
- Volume:
- 181
- Issue:
- 12
- Pages:
- 4199-4209
- Publication date:
- 2022-09-30
- Acceptance date:
- 2022-09-01
- DOI:
- EISSN:
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1432-1076
- ISSN:
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0340-6199
- Pmid:
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36178539
- Language:
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English
- Keywords:
- Pubs id:
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1285741
- Local pid:
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pubs:1285741
- Deposit date:
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2022-12-04
Terms of use
- Copyright holder:
- Tan et al.
- Copyright date:
- 2022
- Rights statement:
- © The Author(s) 2022, corrected publication 2022. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.
- Notes:
- A Correction to this article was published on 21 October 2022. See: https://doi.org/10.1007/s00431-022-04664-9
- Licence:
- CC Attribution (CC BY)
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