Guideline adherence in febrile children below 3 months visiting European Emergency Departments: an observational multicenter study.
Details
Serval ID
serval:BIB_CC93C88F9BD1
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Guideline adherence in febrile children below 3 months visiting European Emergency Departments: an observational multicenter study.
Journal
European journal of pediatrics
Working group(s)
PERFORM consortium (Personalised Risk assessment in febrile children to optimize Real-life Management across the European Union)
Contributor(s)
Levin M., Cunnington A., De T., Herberg J., Kaforou M., Wright V., Baumard L., Bellos E., D'Souza G., Galassini R., Habgood-Coote D., Hamilton S., Hoggart C., Hourmat S., Jackson H., Maconochie I., Menikou S., Lin N., Nichols S., Nijman R., Pena Paz I., Shah P., Shen C.F., Vito O., Wilson C., Abdulla A., Ali L., Darnell S., Jorgensen R., Mustafa S., Persand S., Stevens M., Kim E., Pierce B., Fidler K., Dudley J., Richmond V., Tavliavini E., Liu C.C., Wang S.M., Martinón-Torres F., Salas A., Álvez González F., Balo Farto C., Barral-Arca R., Barreiro Castro M., Bello X., García M.B., Carnota S., Cebey-López M., Curras-Tuala M.J., Durán Suárez C., García Vicente L., Gómez-Carballa A., Gómez Rial J., Leboráns Iglesias P., Martinón-Torres F., Martinón-Torres N., Martinón Sánchez J.M., Mosquera Pérez B., Pardo-Seco J., Piñeiro Rodríguez L., Pischedda S., Vázquez S.R., Rivero Calle I., Rodríguez-Tenreiro C., Redondo-Collazo L., Sadiki Ora M., Salas A., Serén Fernández S., Serén Trasorras C., Vilas Iglesias M., Zavadska D., Balode A., Bārzdiņa A., Deksne D., Gardovska D., Grāvele D., Grope I., Meiere A., Nokalna I., Pavāre J., Pučuka Z., Selecka K., Sidorova A., Svile D., Urbāne U.N., Usuf E., Bojang K., Zaman SMA, Secka F., Anderson S., Roca A., Sarr I., Saidykhan M., Darboe S., Ceesay S., D'alessandro U., Moll H.A., Borensztajn D.M., Hagedoorn N.N., Tan C., Vermont C.L., Zachariasse J., Dik W., Agyeman P., Schlapbach L.J., Aebi C., Wyss V., Usman M., Agyeman P., Schlapbach L.J., Giannoni E., Stocker M., Posfay-Barbe K.M., Heininger U., Bernhard-Stirnemann S., Niederer-Loher A., Kahlert C., Natalucci G., Relly C., Riedel T., Aebi C., Berger C., Carrol E.D., Paulus S., Cocklin E., Jennings R., Johnston J., Leigh S., Newall K., Romaine S., Tsolia M., Eleftheriou I., Tambouratzi M., Marmarinos A., Xagorari M., Syggelou K., Fink C., Voice M., Calvo-Bado L., Zenz W., Kohlmaier B., Schweintzger N.A., Sagmeister M.G., Kohlfürst D.S., Zurl C., Binder A., Hösele S., Leitner M., Pölz L., Rajic G., Bauchinger S., Baumgart H., Benesch M., Ceolotto A., Eber E., Gallistl S., Gores G., Haidl H., Hauer A., Hude C., Keldorfer M., Krenn L., Pilch H., Pfleger A., Pfurtscheller K., Nordberg G., Niedrist T., Rödl S., Skrabl-Baumgartner A., Sperl M., Stampfer L., Strenger V., Till H., Trobisch A., Löffler S., Yeung S., Dewez J.E., Hibberd M., Bath D., Miners A., Nijman R., Wedderburn C., Meierford A., Leurent B., de Groot R., van der Flier M., de Jonge M.I., van Aerde K., Alkema W., van den Broek B., Gloerich J., van Gool A.J., Henriet S., Huijnen M., Philipsen R., Willems E., Gerrits GPJM, van Leur M., Heidema J., de Haan L., Miedema C.J., Neeleman C., Obihara C.C., Tramper-Stranders G.A., Pollard A.J., Kandasamy R., Paulus S., Carter M.J., O'Connor D., Bibi S., Kelly D.F., Gurung M., Thorson S., Ansari I., Murdoch D.R., Shrestha S., Oliver Z., Emonts M., Lim E., Valentine L., Allen K., Bell K., Chan A., Crulley S., Devin K., Fabian D., King S., McAlinden P., McDonald S., McDonnell A., Pickering A., Thomson E., Wood A., Wallia D., Woodsford P., Baxter F., Bell A., Rhodes M., Agbeko R., Mackerness C., Baas B., Kloosterhuis L., Oosthoek W., Arif T., Bennet J., Collings K., van der Giessen I., Martin A., Rashid A., Rowlands E., de Vries G., van der Velden F., Valentine L., Martin M., Mistry R., von Both U., Kolberg L., Zwerenz M., Buschbeck J., Bidlingmaier C., Binder V., Danhauser K., Haas N., Griese M., Feuchtinger T., Keil J., Kappler M., Lurz E., Muench G., Reiter K., Schoen C., Mallet F., Brengel-Pesce K., Pachot A., Mommert M., Pokorn M., Kolnik M., Vincek K., Plankar Srovin T., Bahovec N., Prunk P., Osterman V., Avramoska T., Kuijpers T., Jongerius I., van den Berg J.M., Schonenberg D., Barendregt A.M., Pajkrt D., van der Kuip M., van Furth A.M., Sprenkeler E., Zandstra J., van Mierlo G., Geissler J.
ISSN
1432-1076 (Electronic)
ISSN-L
0340-6199
Publication state
Published
Issued date
12/2022
Peer-reviewed
Oui
Volume
181
Number
12
Pages
4199-4209
Language
english
Notes
Publication types: Observational Study ; Multicenter Study ; Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
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%).
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.
• 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.
• 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.
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.
• 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.
• 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.
Keywords
Child, Humans, Infant, Guideline Adherence, Fever/therapy, Fever/drug therapy, Emergency Service, Hospital, Bacterial Infections/diagnosis, Bacterial Infections/drug therapy, Anti-Bacterial Agents/therapeutic use, Biomarkers, Children, Emergency care, Fever, Guideline, Pediatrics
Pubmed
Web of science
Publisher's website
Open Access
Yes
Create date
28/08/2024 9:22
Last modification date
30/10/2024 7:18
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