Nearly two decades in the making, the American Academy of Pediatrics (AAP) has published the Clinical Practice Guideline for the Evaluation and Management of Well-Appearing Febrile Infants 8-60 Days Old.
Infant Fever Overview
About 14 out of every 1,000 healthy infants born full term develop a fever during the ages 8 days to 60 days old. While most fevers do not lead to severe illness, it can be challenging to immediately identify the cause of a baby’s fever while avoiding unnecessary tests or hospitalizations. More than 10% of febrile infants are diagnosed with a urinary tract infection. The likelihood of a more invasive bacterial infection is much lower, with fewer than .05% of infants developing meningitis, the most serious infection. Some other infections in young infants include pneumonia, sepsis and gastroenteritis.
In its clinical practice guideline, AAP addresses many questions raised in evaluating otherwise well-appearing infants between 8-60 days old who develop a fever at or above 100.4 degrees Fahrenheit (38 degrees Celsius). Based on a comprehensive review of evidence, recommendations are provided for 3 age groups: 8-21 days, 22-28 days, and 29-60 days of age. For each age grouping, seven key action statements are provided: four deal with evaluation (urine, blood culture, inflammatory markers, cerebrospinal fluid), one with initial treatment and two with further management (hospitalization vs. home; cessation of treatment). The guidelines provide a decision-making algorithm for each age group.
Quality Improvement Tools & Resources
The American Academy of Pediatrics seeks to support pediatricians and their care teams through quality improvement in support of the mission that "every child gets the right care every time." The resources below support evaluation of fever and sepsis in infants.
Value in Inpatient Pediatrics (VIP) Network: Reducing Excessive Variability in Infant Sepsis Evaluation (REVISE) Change Package
Podcasts and Voices Blogs
Learn what others are saying. Listen to our podcasts and read our blog posts.
Infants with fevers often get extensive tests and treatment to rule out serious infection. In this AAP Voices blog post, Dr. Anne Vanden Belt shares how to spot babies at risk of life-threatening sepsis.
May 3, 2018
American Academy of Pediatrics