POEMs

Step-by-Step Approach to Ruling Out Infant Infection Is Accurate

 

Am Fam Physician. 2016 Dec 1;94(11):933.

Clinical Question

Is the Step-by-Step approach useful for ruling out systemic infection in young low-risk infants?

Bottom Line

The Step-by-Step approach, using a basic physical examination and readily available urine and blood tests (without lumbar puncture; see the Synopsis section), can successfully identify low-risk infants younger than 90 days who will not need empiric antibiotic treatment and lumbar puncture. However, this approach has not been studied (nor has any other approach, I believe) in a randomized controlled trial to see whether it is effective at decreasing lumbar punctures or hospital admissions. (Level of Evidence = 1a)

Synopsis

This study was conducted at 11 European pediatric emergency departments. The researchers

POEMs (patient-oriented evidence that matters) are provided by EssentialEvidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

To subscribe to a free podcast of these and other POEMs that appear in AFP, search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of POEMs published in AFP is available at http://www.aafp.org/afp/poems.


 

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