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The American Academy of Pediatrics currently recommends routine cerebrospinal fluid (CSF) testing, antibiotics, and hospital admission for well-appearing febrile infants 8 to 21 days old, to rule out invasive bacterial infection. Decisions about these same interventions in slightly older infants (22 to 60 days) can be guided by a prediction rule from the Pediatric Emergency Care Applied Research Network (PECARN).
Now, researchers report on the use of this rule among 1500 young febrile infants across Canada and five European countries between 2008 and 2024. All the infants were full term, previously healthy, well-appearing, and 28 days and younger at the time of fever; 35% were 22 to 28 days of age, and 60% were male. Blood and urine c…