Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Tan, CD; van, der, Walle, EEPL; Vermont, CL; von, Both, U; Carrol, ED; Eleftheriou, I; Emonts, M; van, der, Flier, M; de, Groot, R; Herberg, J; Kohlmaier, B; Levin, M; Lim, E; Maconochie, IK; Martinon-Torres, F; Nijman, RG; Pokorn, M; Rivero-Calle, I; Tsolia, M; Yeung, S; Zenz, W; Zavadska, D; Moll, HA, , PERFORM, consortium, (Personalised, Risk, assessment, in, febrile, children, to, optimize, Real-life, Management, across, the, European, Union).
Guideline adherence in febrile children below 3 months visiting European Emergency Departments: an observational multicenter study.
Eur J Pediatr. 2022; 181(12):4199-4209
Doi: 10.1007/s00431-022-04606-5
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- Co-Autor*innen der Med Uni Graz
- Kohlmaier Benno
- Zenz Werner
- Study Group Mitglieder der Med Uni Graz:
- Bauchinger Sebastian
- Baumgart Hinrich
- Benesch Martin
- Binder Alexander
- Eber Ernst
- Gallistl Siegfried
- Gores Gunther
- Haidl Harald
- Hauer Almuthe
- Keldorfer Markus
- Kohlfürst Daniela
- Krenn Larissa
- Leitner Manuel
- Löffler Sabine
- Niedrist Tobias
- Nordberg Gudrun
- Pfleger Andreas
- Pfurtscheller Klaus
- Pilch Heidemarie
- Pölz Lena
- Rajic Glorija
- Roedl Siegfried
- Sagmeister Manfred Gerald
- Schweintzger Nina
- Skrabl-Baumgartner Andrea
- Sperl Matthias
- Stampfer Laura
- Strenger Volker
- Till Holger
- Trobisch Andreas
- Zurl Christoph Johann
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- Abstract:
- UNLABELLED: 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. WHAT IS KNOWN: • 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 of young febrile children due to differences in guidelines and their usage and adherence. WHAT IS NEW: • Full guideline adherence is limited, whereas partial guideline adherence is moderate in febrile children below 3 months across Europe. • Guideline revision including new biomarkers is needed to improve management in young febrile children.
- Find related publications in this database (using NLM MeSH Indexing)
- Child - administration & dosage
- Humans - administration & dosage
- Infant - administration & dosage
- Guideline Adherence - administration & dosage
- Fever - therapy, drug therapy
- Emergency Service, Hospital - administration & dosage
- Bacterial Infections - diagnosis, drug therapy
- Anti-Bacterial Agents - therapeutic use
- Biomarkers - administration & dosage
- Find related publications in this database (Keywords)
- Fever
- Children
- Pediatrics
- Guideline
- Emergency care