What is included in inpatient care 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

Answer

All febrile neonates aged 0-28 days old should be hospitalized for presumed sepsis and treated with antibiotics until cultures of CSF, blood, and urine are all negative for growth after 48 hours. [122, 115, 123] Two parenteral antibiotics are administered during these inpatient admissions: an aminopenicillin, such as ampicillin, and either a cephalosporin, such as cefotaxime, or an aminoglycoside such as gentamicin.

If admitted, febrile patients outside of the neonatal period are prophylactically treated with an antibiotic (eg, a third-generation cephalosporin, such as ceftriaxone), until cultures are shown to be negative. [124]

Iatrogenic risks are involved with routine hospitalizations of all febrile neonates and young infants. [114] Protocols developed in advance, in cooperation with the ED staff as well as the pediatric staff, streamline the approach at each institution.

If the initial facility is not designed for pediatric inpatient care, transfer to a pediatric facility as needed after his or her condition is stabilized in the ED and after initial workup and treatments are completed.


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