Don’t continue hospitalization in well-appearing febrile infants once bacterial cultures (i.e., blood, cerebrospinal, and/or urine) have been confirmed negative for 24 to 36 hours, if adequate outpatient follow-up can be assured.
|Rationale and Comments:||Routinely continuing hospitalization beyond 24 to 36 hours of confirmed negative bacterial cultures for well-appearing infants admitted for concern of serious bacterial infection does not improve clinical outcomes. Blood culture yield is highest in the first 12 to 36 hours after incubation with multiple studies demonstrating > 90% of pathogen cultures being positive by 24 hours. If adequate outpatient follow-up can be assured, discharging well-appearing febrile infants at 24 to 36 hours if cultures are confirmed to be negative will decrease length of stay, antibiotic exposure, and iatrogenic complications.|
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