IN THIS ISSUE of the ARCHIVES, Newman et al1 present data from the Pediatric Research in Office Settings' (PROS) Febrile Infant Study, one of several articles we look forward to seeing from this remarkable data set. The article addresses urinary tract infections (UTIs) in febrile infants younger than 3 months who were seen in office practices.
As one of their study questions, the authors ask, Do practitioners follow published practice guidelines, referring specifically to routine urine testing for UTI in the evaluation of febrile infants? Of the 3066 infants enrolled in the PROS Febrile Infant Study, only 1775 had their urine tested. Therefore, the answer is no. The conclusion that practitioners do not follow guidelines is not unexpected given the results of studies cited by the authors, but Newman and colleagues suggest a more provocative question: Should practitioners be following published guidelines in this situation, or is what they are currently doing working just fine? That question generates others, all of which deserve consideration.
Roberts KB. Urinary Tract Infections in Young Febrile InfantsIs Selective Testing Acceptable?. Arch Pediatr Adolesc Med. 2002;156(1):6-7. doi:10.1001/archpedi.156.1.6