I have agreed with many of the recent review articles citing the following studies that application of either the Rochester Criteria, Boston or Philly Criteria on infants less than 1 month of age has an approximate miss rate of SBI of about 1%.
I personally admit and treat all infants less than 1 month of age.
Peds ER Attending
Children's Hospital of Western Ontario
üJaskiewicz JA et al., Febrile infants at low risk for serious bacterial infection: An appraisal of the Rochester Criteria and implications for management. Pediatrics 94:390-396, 1994
Baker MD, Bell LM: The applicability of an established outpatient management protocol for febrile 0-1 month old infants. Pediatrics 103:627-631, 1999
Kadish JA, Bolte RB, Tobey J, et al: Applying outpatient protocols in febrile infants 1-29 days of age: Can the threshold be lowered [abstract]. Presented at the 38th Annual Meeting of the Ambulatory Pediatric Association. New Orleans, May 4, 1998
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