Iranian Journal of Pediatrics
Tehran University of Medical Sciences Press
Vol. 21, No. 4, 2011, pp. 436-440
Bioline Code: pe11075
Full paper language: English
Document type: Research Article
Document available free of charge
Iranian Journal of Pediatrics, Vol. 21, No. 4, 2011, pp. 436-440
© Copyright 2011 Iran Journal of Pediatrics
Assessment of Febrile Neonates According to Low Risk Criteria for Serious Bacterial Infection|
Zarkesh, Marjaneh; Hashemian, Houman; Momtazbakhsh, Mohammad & Rostami, Tahereh
Objective: It is propounded that febrile neonates with low risk criteria (LRC) can be carefully
observed without parenteral antimicrobial therapy; but yet, reliability of LRC to exclude serious
bacterial infection (SBI) is uncertain.
Methods: The records of all febrile term neonates, seen in the emergency room and admitted in
neonatal ward of 17 Shahrivar children's hospital of Rasht, Iran from January 2004 to January 2009
were reviewed. All of them underwent full sepsis workup. The prevalence of SBI in total population
and LRC positive and negative neonates were calculated
Findings: A total of 202 records of previously healthy febrile neonates were evaluated. SBI was
shown in 38 (18.8%). The most common type of SBI was urinary tract infection (UTI). Sixty-two
(31%) neonates had LRC, and only one (1.6%) had SBI (UTI with E. coli). SBI was significantly more
common in neonates without LRC (26.6% versus 1.6%, P<0.001). The negative predictive value
(NPV) of LRC to exclude SBI was 98.4% (95%confidence interval: 96.7% to 100%).
Conclusion: These findings suggest that LRC may be relied upon to exclude SBI in febrile neonates.
We propose that all febrile neonates be admitted, ill or LRC negative neonates should undergo a full
sepsis work up and be administered systemic antibiotics immediately. LRC positive neonates should
be under close observation.
Low-risk criteria; Neonate; Serious bacterial infection
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