Hospitalization and administration of antibiotics to infants with fevers is unnecessary with proper screening criteria.

Findings by researchers in Philadelphia dispute the traditional practice of treating children who are less than three months old suffering temperatures above 38C. Usually they are automatically hospitalized and subjected to a battery of tests (everything from a complete blood count to a lumbar puncture) and given intravenous antibiotics until the results of all the tests become available.

However, the researchers found that stringent screening criteria during the initial tests can determine which children are likely to be at risk of serious diseases like meningitis and need aggressive treatment and those in which the fever is benign.

The researchers examined 747 babies who each had temperatures of at least 38.2C. A third of those, who had "unremarkable examinations and normal laboratory results", were assigned either to inpatient observation without antibiotics, or to outpatient care without antibiotics but with reexamination at 24 and 48 hours.

Of the 287 children treated without antibiotics, 286 did not have serious bacterial illness. Only two of those initially categorized as outpatients were subsequently hospitalized and neither was found to have a serious condition. All but one of the 65 children who did have serious bacterial illness were identified by the screening criteria.