Guideline adherence in febrile children below 3 months visiting European Emergency Departments

Autor:	Tan, C.D., Walle, E.E.P.L. van der, Vermont, C.L., Both, U. von, Carrol, E.D., Eleftheriou, I., Emonts, M., Flier, M. van der, Groot, R. de, Herberg, J., Kohlmaier, B., Levin, M., Lim, E., Maconochie, I.K., Martinon-Torres, F., Nijman, R.G., Pokorn, M., Rivero-Calle, I., Tsolia, M., Yeung, S., Zenz, W., Zavadska, D., Neeleman, C., Gool, A.J. van, Gloerich, J., Huijnen, M.A., Moll, H.A.
Přispěvatelé:	Pediatrics, Internal Medicine, Radiation Oncology, AII - Infectious diseases, Amsterdam Reproduction & Development (AR&D), European Commission, National Institute of Health and Medical Research, Adult Psychiatry, APH - Mental Health, ANS - Complex Trait Genetics, ANS - Mood, Anxiety, Psychosis, Stress & Sleep, Landsteiner Laboratory, Paediatric Infectious Diseases / Rheumatology / Immunology, ARD - Amsterdam Reproduction and Development, AII - Inflammatory diseases, Paediatrics, Graduate School, University of Zurich, Union), PERFORM consortium (Personalised Risk assessment in febrile children to optimize Real-life Management across the European
Jazyk:	angličtina
Rok vydání:	2022
Předmět:	Fever lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] INFANTS 610 Medicine & health Guideline Pediatrics 1117 Public Health and Health Services Humans Child Children Science & Technology PERFORM consortium (Personalised Risk assessment in febrile children to optimize Real-life Management across the European Union) Infant Metabolic Disorders Radboud Institute for Molecular Life Sciences [Radboudumc 6] SERIOUS BACTERIAL-INFECTIONS Bacterial Infections 10027 Clinic for Neonatology Anti-Bacterial Agents lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] Pediatrics Perinatology and Child Health 1114 Paediatrics and Reproductive Medicine Emergency care Guideline Adherence Emergency Service Hospital Life Sciences & Biomedicine Biomarkers
Zdroj:	European Journal of Pediatrics, 181, 4199-4209 European Journal of Pediatrics, 181(12), 4199-4209. Springer-Verlag European Journal of Pediatrics, 181(12), 4199-4209. Springer Verlag European Journal of Pediatrics, 181, 12, pp. 4199-4209 European journal of pediatrics, 181(12), 4199-4209. Springer Verlag PERFORM consortium (Personalised Risk assessment in febrile children to optimize Real-life Management across the European Union) 2022, ' Guideline adherence in febrile children below 3 months visiting European Emergency Departments : an observational multicenter study ', European Journal of Pediatrics, vol. 181, no. 12, pp. 4199-4209 . https://doi.org/10.1007/s00431-022-04606-5
ISSN:	0340-6199
Popis:	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 guidelines and their usage and adherence. What is New:• Full guideline adherence is limited, whereas partial guideline adherence is moderate in febrile children below 3 months across Europe.• Guideline revision including new biomarkers is needed to improve management in young febrile children.
Databáze:	OpenAIRE
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