Prompted by the inefficiency of current fever management in young infants, lead author Richard Bachur, MD, Children's Hospital Boston, Boston, Massachusetts, and colleagues sought a rapid diagnostic test that could determine which children have serious infections at the first visit to the ED.

"We hope to identify those infants that are at very low risk of serious infection and tailor their evaluation so as to minimise invasive testing and exposure to unnecessary antibiotics," said Dr. Bachur.

"About 12% of those whom we consider 'well appearing' end up having serious infections when we do an evaluation."

The researchers used a novel procalcitonin test in 234 feverish babies aged under 3 months, of whom 18% had definite or possible SBIs confirmed by independent clinical criteria.

The results showed that procalcitonin not only detected all cases of SBIs in feverous infants but also proved sensitive enough to establish a threshold value that would identify infants at low risk for serious infections.

The high sensitivity of the new procalcitonin test has allowed researchers to establish realistic cut-off values to help guide clinicians in identifying children who are at low risk for SBIs.

The researchers are now looking to do a multicentre study to evaluate the use of procalcitonin on a larger scale. If it proves to be valuable, Dr. Bachur hopes it will become a standard tool for the evaluation of young infants with fever.


SOURCE: Children's Hospital Boston

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