Researchers from UC Davis Health in Sacramento, Calif.; University of Michigan in Ann Arbor; Nationwide Children’s Hospital in Columbus, Ohio; and Columbia University in New York City developed the new protocol.
The protocol instructs clinicians to screen infants that come to the ED with a fever for three things:
- Bacteria levels in urine
- Procalcitonin, a substance produced in response to bacterial infections
- Neutrophils, a type of white blood cell that fights infection
To test the protocol, researchers examined data on 1,821 infants under 2 months old who presented at 26 EDs nationwide with fevers between March 2011 and May 2013. Clinicians used the new protocol on a random sample of 908 infants and validated it on 913 other infants.
Researchers found the new protocol allowed clinicians to more precisely rule out infants at risk of serious bacterial infections, thereby limiting the need for spinal taps, antibiotic prescriptions and hospitalizations. However, they noted further validation is needed before EDs fully implement the protocol.
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