Table 2 Clinical and laboratory findings of common low‐risk criteria. Adapted from [12]
From: Facing the ongoing challenge of the febrile young infant
Boston | Milwaukee | Philadelphia | Rochester | |
|---|---|---|---|---|
Age range | 28–89 days | 28–56 days | 29–60 days | ≤60 days |
History | No immunizations or antimicrobials in prior 48 h | Not defined | Not defined | Term infant; no prior antibiotics; no underlying disease; no hospitalization longer than mother |
Physical exam | Well appearing; no signs of focal infection | Well appearing; no signs of focal infection | Well appearing; no signs of focal infection | Well appearing; no signs of focal infection |
Laboratory parameters | CSF < 10 WBC/mm3 WBC < 20,000 mm3 UA < 10 WBC/hpf CXR without infiltrate (if obtained) | CSF < 10/mm3 WBC < 15,000/mm3 UA < 5–10 WBC/hpf; UA no bacteria, negative leukocyte esterase, negative nitrites CXR without infiltrate | CSF < 8 WBC/mm3 WBC < 15,000/mm3 UA < 10 WBC/hpf CXR without infiltrate (if obtained) | WBC > 5000 and < 15,000/mm3 ABC < 1500/mm3 UA ≤ 10 WBC/hpf CXR without infiltrate (if obtained) Stool: WBC ≤ 5/hpf smear (if indicated) |
Management strategies for high risk | Hospitalize, empiric antibiotics | Not defined | Hospitalize, empiric antibiotics | Hospitalize, empiric antibiotics |
Management strategy for low risk | Home/outpatient ok Empiric antibiotics, outpatient follow up required | Home/outpatient ok i.m. ceftriaxone 50 mg/kg followed by outpatient follow up within 24 h Must have reliable caretaker | Home/outpatient ok No antibiotics, but outpatient follow up is required | Home/outpatient ok No antibiotics, but outpatient follow up is required |