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Comment & Response
August 19, 2019

Efficacy of a Clinical Prediction Rule to Identify Febrile Young Infants at Low Risk for Serious Bacterial Infections

Author Affiliations
  • 1Division of Pediatric Emergency Medicine, Montreal Children’s Hospital, Montreal, Quebec, Canada
  • 2Division of Pediatric Infectious Diseases, Montreal Children’s Hospital, Montreal, Quebec, Canada
JAMA Pediatr. 2019;173(10):997-998. doi:10.1001/jamapediatrics.2019.2653

To the Editor Fever among infants in the first months of life remains one of the most commonly encountered clinical problems in all pediatric health care. Although most are viral illnesses, approximately 10% are potentially life-threatening serious bacterial infections (SBIs). Risk stratification criteria developed nearly 30 years ago provide conflicting recommendations and predate the availability of newer diagnostic tests with improved ability to discriminate high-risk infants. The most widely used risk stratification strategy, the Rochester criteria,1 was derived from just 233 infants in 1985. Statistical methods unavailable at the time now allow the derivation of more robust prediction rules incorporating variables from the clinical history, physical examination, and laboratory tests to facilitate diagnostic and therapeutic decision-making.