Maryam Razavi

maryam.razavi@cambio.se

@CambioCDS

To assist clinicians to determine whether febrile infants are at low risk for serious bacterial infection.

Use in infants ≤60 days old presenting to the emergency department for a chief complaint of fever ≥38ºC (100.4ºF), or found to have a fever on a presentation for another complaint. Rochester Criteria and assigned points: - Infant appears generally well: No=0, Yes=1 - No evidence of focal infection: No=0, Yes=1 No prior illness: - Born at term (≥37 weeks gestation): No=0, Yes=1 - No perinatal antibiotics: No=0, Yes=1 - No unexplained hyperbilirubinemia: No=0, Yes=1 - No previous hospitalizations: No=0, Yes=1 - No chronic or underlying illness: No=0, Yes=1 - Not hospitalized longer than mother after delivery: No=0, Yes=1 Lab values - WBC 5,000-15,000/mm³ (5-15 × 10⁹/L): No=0, Yes=1 - Band neutrophils ≤1,500/mm³ (≤1.5 × 10⁹/L): No=0, Yes=1 - Urine WBC <10 WBC/hpf: No=0, Yes=1 - No diarrhea; or, if diarrhea present, fecal leukocytes <5 WBC/hpf: No=0, Yes=1 Interpretations: Criteria 12: - Low risk (<1%) for SBI - Recommendations: Obtain limited tests: CBC, blood culture, urinalysis, and urine culture; antibiotics not necessary and consider discharge with close PCP follow-up. Criteria>12: - Not low risk for SBI - Recommendation: Obtain CBC, blood culture, urinalysis, urine culture, and CSF; empiric antibiotics indicated and admit pending negative cultures at 24-36 hrs and continued well-appearance.

1. Dagan R, Powell KR, Hall CB, Menegus MA. Identification of infants unlikely to have serious bacterial infection although hospitalized for suspected sepsis. J Pediatr. 1985;107(6):855-60. 2. Jaskiewicz JA, Mccarthy CA, Richardson AC, et al. Febrile infants at low risk for serious bacterial infection--an appraisal of the Rochester criteria and implications for management. Febrile Infant Collaborative Study Group. Pediatrics. 1994;94(3):390-6.

OBSERVATION.basic_demographic.v1, OBSERVATION.body_temperature.v2, OBSERVATION.rochester_criteria.v0