Prospective multicenter evaluation of adherence to the Dutch guideline for children aged 0–16 years with fever without a source—febrile illness in children (FINCH) study

• DOI: 10.1007/s00431-024-05553-z
• Publication Date: 2024-04-15T15:02:20Z
• Authors: Maya W. Keuning; Nikki N. Klarenbeek; Hidde J. Bout; Amber Broer; Melvin Draaijer; Jeroen Hol; Nina Hollander; Marieke Merelle; Amara Nassar-Shei...; Charlotte Nusman; Emma Oostenbroek; Milan L. Ridderikhof; Manouck Roelofs; Ellen van Rossem; Sophie R. D. van ...; Sarah M. Schouten; Pieter Taselaar; Koen Vasse; Anne-Marie van We...; Julia M. J. van d...; Roy Zuurbier; Merijn W. Bijlsma; Dasja Pajkrt; Frans B. Plötz
• Keywords: Guideline

Evaluation of guidelines in actual practice is a crucial step guideline improvement. A retrospective evaluation the Dutch for children with fever without an apparent source (FWS) showed 50% adherence young infants. We prospectively evaluated to and its impact on management current practice. Prospective observational multicenter cross-sectional study, including 3 days 16 years old presented FWS at one seven emergency departments participating secondary tertiary care hospitals Netherlands. Adherence guideline, adapted from National Institute Health Care Excellence (NICE) was evaluated, patterns non-adherence clinical outcomes resource use were explored. 192/370 (52%). lowest patients categorized as high risk severe infection (72/187, 39%), compared low-risk group (64/73, 88%). Differences significant between categories (P < 0.001) but not age categories. In case non-adherence, less urinalysis, fewer bacterial cultures (blood, urine, cerebral spinal fluid), empirical antibiotic treatment performed 0.050). Clinical significantly different group, particularly regarding missed infections.