Variation in the Evaluation of Well-Appearing Febrile Infants Persists

Using records from Kaiser Permanente Northern California, researchers identified a cohort of 1380 full-term healthy infants born between 2010 and 2013 who presented with fever between age 7 days and 90 days (incidence rate, 14.4 per 1000 full-term births). Of these infants, 14% had a bacterial infection (urinary tract infection [UTI] in 13.2%, bacteremia in 2.6%, and meningitis in 0.3%). Rates of infection were 19% in those aged 7 to 28 days, 14% in those 29 to 60 days, and 11% in those 61 to 90 days.

Cultures were obtained for only 68% of infants. Infants presenting to an emergency department were five times more likely to have cultures than those presenting to a primary care office. A full sepsis evaluation was performed for 59% of infants…