The dogma of identifying occult bacterial infections in young febrile children: A survey of primary-care physicians

Management of undifferentiated febrile illness in young children continues to be a controversial issue among primary-care physicians. A self administe red questionnaire was mailed to 600 randomly selected physicians regarding their management of children with high fever and no focus of infection at v arious ages: 3 weeks, 7 weeks, 4 months and 20 months. Completed questionna ires were returned by 419 (70%) physicians. Nearly 77% of physicians would hospitalise a 3-week old infant with fever and 70% would treat these infant s empirically with antibiotics. Sixty-one per cent of physicians would hosp italise a 7-week-old infant with fever and 46% would treat empirically with antibiotics. Approximately 80% and 93% of physicians, respectively, would not hospitalise 4- and 20-month-old infants with high fever and no focus of infection, but 72% and 59%, respectively, would treat such infants with an tibiotics. There was considerable variation in the way physicians managed y oung febrile children with no focus of infection and the clinical approach of some physicians was remarkably different from current knowledge and reco mmendations.