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  • Follow-up analysis of serious bacterial infections in children with fever without localising signs: how do the National Institute for Clinical Excellence guidelines perform with the emergence of non-vaccine pneumococcal serotypes?

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Follow-up analysis of serious bacterial infections in children with fever without localising signs: how do the National Institute for Clinical Excellence guidelines perform with the emergence of non-vaccine pneumococcal serotypes?
  1. E A Waddle1,
  2. K E Hanson2,3,
  3. R Jhaveri1
  1. 1
    Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
  2. 2
    Department of Medicine, Duke University Medical Center, Durham, North Carolina
  3. 3
    Department of Pathology, Duke University Medical Center, Durham, North Carolina
  1. Ravi Jhaveri, Division of Pediatric Infectious Diseases, DUMC Box 3499, Duke University Medical Center, Durham, North Carolina 27710, USA; ravi.jhaveri{at}duke.edu

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    After the recommendation in 2006 for PCV7 to be used in the UK, the 2007 National Institute for Health and Clinical Excellence (NICE) guidelines for management of feverish children recommended only evaluation of the urine in children with fever without localising signs (FWLS) that met the “green” criteria.1 In a previous study published in this journal, we presented data supporting the NICE guidelines.2 Reports describing the emergence of non-vaccine serotypes of Streptococcus pneumoniae, specifically 19A, have raised concerns about increasing …

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    Footnotes

    • Competing interests: None.

    • Ethics approval: This research project was reviewed and approved by the Duke University Institutional Review Board.

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    2009 BMJ Publishing Group & Royal College of Paediatrics and Child Health