Bacterial infections often missed in febrile children in the ER

February 01, 2016

According to authors there are often reasons for withholding immediate antibiotics even when bacterial infections are suspected. For example a blood or urine culture needs to be done before administration of antibiotics that can distort the original infection picture in reports. But a delay in the administration of antibiotics can also cause recurrence of the infection. The authors thus recommend two methods to deal with the problem:

Use of a computer algorithm like the one they devised to aid diagnosis Use a more standardized, evidence-based interpretation of urinalysis and chest radiograph results

Point of view

But two researchers (Matthew J. Thompson and Ann Van den Bruel) from the University of Oxford in England have written in the editorial of the same issue that it would be some time before adoption of these measures may be deemed appropriate. They wrote, ???Before widespread implementation, we will need to have evidence showing the effect of using such a model on patient management and outcomes.??? They also suggested inclusion of other infections like meningitis, osteomyelitis or bone infection and septic arthritis or infection of joints. They wrote, ???These are rare but crucial to identify, so excluding them may limit the model's usefulness.???

Lacunae

The original study researchers have mentioned some of the drawbacks of their study like inadequacy of microbiological and/or radiological verification in some children and no concrete estimates of the prevalence of these illnesses in the emergency.