Why is the presumptive use of broad-spectrum antibiotics strongly discouraged in the emergent management of pediatric patients with fever?

Updated: Jul 23, 2019
  • Author: Hina Z Ghory, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Similarly, the presumptive use of broad-spectrum antibiotics is strongly discouraged because of low bacteremia and complication rates, high costs, adverse drug reactions, and increasing rates of antibiotic resistance due to indiscriminate antibiotic use, as well as because the outcomes for febrile young children not treated presumptively with parenteral antibiotics are uniformly good.

For clinically ill-appearing children, a sepsis workup to include a blood culture should be obtained. Use of serum markers for sepsis, including a lactate level and procalcitonin, have been described as being helpful in stratifying the sickest children. [83, 84, 85, 86] This is especially true in children ill enough to warrant an LP as described above, those exhibiting signs of shock, or those with a petechial rash.


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