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Title:Guideline adherence in febrile children below 3 months visiting European Emergency Departments : an observational multicenter study
Authors:ID Tan, Chantal D. (Author)
ID van der Walle, Eline E. P. L. (Author)
ID Vermont, Clementien L. (Author)
ID Von Both, Ulrich (Author)
ID Carrol, Enitan D (Author)
ID Eleftheriou, Irini (Author)
ID Emonts, Marieke (Author)
ID Van der Flier, Michiel (Author)
ID De Groot, Ronald (Author)
ID Pokorn, Marko (Author)
ID Kolnik, Mojca (Research coworker)
ID Vincek, Katarina (Research coworker)
ID Plankar Srovin, Tina (Research coworker)
ID Bahovec, Natalija (Research coworker)
ID Prunk, Petra (Research coworker)
ID Osterman, Veronika (Research coworker)
ID Avramoska, Tanja (Research coworker), et al.
Files:.pdf PDF - Presentation file, download (917,52 KB)
MD5: BBD4A655142B2D0DD015BE1BB9E2173E
 
URL URL - Source URL, visit https://link.springer.com/article/10.1007/s00431-022-04606-5
 
Language:English
Typology:1.01 - Original Scientific Article
Organization:Logo UKC LJ - Ljubljana University Medical Centre
Abstract: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.
Keywords:fever, children, pediatrics, guideline, emergency care
Publication status:Published
Publication version:Version of Record
Year of publishing:2022
Number of pages:str. 4199-4209
Numbering:Vol. 181, issue 12
PID:20.500.12556/DiRROS-24137 New window
UDC:616-053.2
ISSN on article:1432-1076
DOI:10.1007/s00431-022-04606-5 New window
COBISS.SI-ID:243357955 New window
Note:Nasl. z nasl. zaslona; Opis vira z dne 22. 7. 2025;
Publication date in DiRROS:17.11.2025
Views:119
Downloads:62
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Record is a part of a journal

Title:European journal of pediatrics
Shortened title:Eur. j. pediatr.
Publisher:Springer
ISSN:1432-1076
COBISS.SI-ID:513665561 New window

Document is financed by a project

Funder:EC - European Commission
Project number:848196
Name:Diagnosis and Management of Febrile Illness using RNA Personalised Molecular Signature Diagnosis
Acronym:DIAMONDS

Licences

License:CC BY 4.0, Creative Commons Attribution 4.0 International
Link:http://creativecommons.org/licenses/by/4.0/
Description:This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

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