![\"Step](\"https:\/\/i0.wp.com\/www.emlitofnote.com\/wp-content\/uploads\/2016\/07\/Screen-Shot-2016-07-22-at-4.54.59-PM.png?resize=840%2C980&ssl=1\")
<\/p>\nYou\u2019ve heard of the Philadelphia Criteria. You\u2019ve heard of the Rochester Criteria. But \u2013 Step-by-Step?<\/p>\n
This is an algorithm developed by European emergency physicians to identify low-risk infants who could be safely managed without lumbar puncture nor empiric antibiotic treatment. After retrospectively validating their algorithm on 1,123 patients, this is their prospective validation in 2,185 \u2013 looking for IBI or \u201cInvasive Bacterial Infection\u201d as their primary outcome.<\/p>\n
The easiest way to summarize their algorithm and results is by this figure:<\/p>\n
<\/p>\n
Sensitivity and specificity, respectively, were as follows:<\/p>\n
The authors attribute 6 of the 7 missed by Step-by-Step to evaluation early in the disease process \u2013 presentation within 2 hours of onset of fever.<\/p>\n
Their algorithm is reasonable at face validity, and could be incorporated into a protocol with close follow-up to re-evaluate those early in their disease process. We still have, however, a long way to go regarding specificity.<\/p>\n
\u201cValidation of the \u201cStep-by-Step\u201d Approach in the Management of Young Febrile Infants\u201d You\u2019ve heard of the Philadelphia Criteria. You\u2019ve heard of the Rochester Criteria. But \u2013 Step-by-Step? This is an algorithm developed by European emergency physicians to identify low-risk infants who could be safely managed without lumbar puncture nor empiric antibiotic treatment. After retrospectively validating their algorithm on 1,123 patients, this is their prospective validation in 2,185 … Continue reading “The Febrile Infant Step-by-Step”<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[5,9,29,1],"tags":[],"class_list":["post-3519","post","type-post","status-publish","format-standard","hentry","category-clinical-decision-rules","category-infectious-disease","category-pediatrics","category-uncategorized"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p7KesJ-UL","_links":{"self":[{"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/posts\/3519","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3519"}],"version-history":[{"count":1,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/posts\/3519\/revisions"}],"predecessor-version":[{"id":3521,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/posts\/3519\/revisions\/3521"}],"wp:attachment":[{"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3519"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3519"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3519"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
\nhttp:\/\/www.ncbi.nlm.nih.gov\/pubmed\/27382134<\/a><\/p>\n\nTweet<\/a><\/div>\n","protected":false},"excerpt":{"rendered":"