Imperial College London
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DrJethroHerberg

Faculty of Medicine, Department of Infectious Disease

Clinical Reader in Paediatric Infectious Disease
 
 
 
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Contact

 

j.herberg

 
 
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Location

 

231Wright Fleming WingSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Tan:2022:10.1007/s00431-022-04606-5,
author = {Tan, CD and van, der Walle EEPL and Vermont, CL and von, Both U and Carrol, ED and Eleftheriou, I and Emonts, M and van, der Flier M and de, Groot R and Herberg, J and Kohlmaier, B and Levin, M and Lim, E and Maconochie, IK and Martinon-Torres, F and Nijman, RG and Pokorn, M and Rivero-Calle, I and Tsolia, M and Yeung, S and Zenz, W and Zavadska, D and Moll, HA and PERFORM, consortium Personalised Risk assessment in febrile children to optimize Real-life Management across the European Union},
doi = {10.1007/s00431-022-04606-5},
journal = {European Journal of Pediatrics},
pages = {4199--4209},
title = {Guideline adherence in febrile children below 3 months visiting European Emergency Departments: an observational multicenter study},
url = {http://dx.doi.org/10.1007/s00431-022-04606-5},
volume = {181},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - 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 guideline
AU  - Tan,CD
AU  - van,der Walle EEPL
AU  - Vermont,CL
AU  - von,Both U
AU  - Carrol,ED
AU  - Eleftheriou,I
AU  - Emonts,M
AU  - van,der Flier M
AU  - de,Groot R
AU  - Herberg,J
AU  - Kohlmaier,B
AU  - Levin,M
AU  - Lim,E
AU  - Maconochie,IK
AU  - Martinon-Torres,F
AU  - Nijman,RG
AU  - Pokorn,M
AU  - Rivero-Calle,I
AU  - Tsolia,M
AU  - Yeung,S
AU  - Zenz,W
AU  - Zavadska,D
AU  - Moll,HA
AU  - PERFORM,consortium Personalised Risk assessment in febrile children to optimize Real-life Management across the European Union
DO  - 10.1007/s00431-022-04606-5
EP  - 4209
PY  - 2022///
SN  - 0340-6199
SP  - 4199
TI  - Guideline adherence in febrile children below 3 months visiting European Emergency Departments: an observational multicenter study
T2  - European Journal of Pediatrics
UR  - http://dx.doi.org/10.1007/s00431-022-04606-5
UR  - https://www.ncbi.nlm.nih.gov/pubmed/36178539
UR  - https://link.springer.com/article/10.1007/s00431-022-04606-5
UR  - http://hdl.handle.net/10044/1/100064
VL  - 181
ER  -
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