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Recent National Institute for Health and Care Excellence (NICE) guidance on sepsis1 defines clinical criteria to guide the management of a child presenting with suspected infection (table 1). In children with suspected infection, presence of a ‘high-risk’ criterion should lead to intravenous access, parenteral antibiotic administration and consideration of intravenous fluid boluses, unless a senior decision-making doctor (DMD; defined as a Specialist Trainee (ST) 4 paediatrician, or ST4 emergency physician for older children) makes an alternative diagnosis.
Since clinical screening criteria for sepsis are non-specific,2 many children without sepsis may receive antibiotic treatment for each case of true sepsis. NICE guidance might unintentionally exacerbate this, diverting …
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