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Stop using the Boston and Philadelphia criteria for assessing the risk of sepsis in febrile infants

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When faced with an infant between the ages of 29 and 60 days presenting with a fever, there are various prediction rules or risk assessment tools that can be used to identify those at low risk of serious bacterial infection (SBI). The Boston and Philadelphia criteria were developed over twenty years ago to identify young, febrile infants at low risk for SBI who may be safely discharged from emergency departments and children’s assessment units. The Archivist continues to see these criteria included in some hospital guidelines. The epidemiology of SBI has changed since the development of conjugate vaccines. How useful are these criteria …

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