Detecting serious bacterial infections (SBI) in children presenting to the Pediatric Emergency Department (PED) with fever without source (FWS) is a frequent diagnostic challenge. The recently described Lab-score, based on the combined determination of Procalcitonin, C-Reactive Protein (CRP) and urine dipstick results, has been shown an accurate tool for SBI prediction on retrospective cohorts. The investigators aimed to assess the usefulness of the Lab-score in safely decreasing unnecessary antibiotic prescriptions in children with FWS, and to prospectively determine the diagnostic characteristics of the Lab-score compared to other classically used SBI biomarkers (white blood cell (WBC) count, band count and CRP).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
278
Children's Hospital, Geneva University Hospital
Geneva, Geneva 14, Switzerland
Antibiotic Prescription Rate
Time frame: at PED (Pediatric Emergency Department) presentation
Presence of Serious Bacterial Infection
Time frame: at 72 hours from PED presentation
Hospitalization Rate
Time frame: at PED presentation
Sensitivity of a Lab-score ≥ 3
Time frame: at 72 hours from PED presentation
Specificity of a Lab-score ≥ 3
Time frame: at 72 hours from PED presentation
Sensitivity of Standard Biological Marker for SBI
Sensitivity of standard biological marker for SBI: WBC ≥ 15'000/mm³ and/or bands ≥ 1'500/mm³ and/or CRP ≥ 40 mg/L
Time frame: at 72 hours from PED presentation
Specificity of Standard Biological Marker for SBI
Specificity of standard biological marker for SBI: WBC ≥ 15'000/mm³ and/or bands ≥ 1'500/mm³ and/or CRP ≥ 40 mg/L
Time frame: at 72 hours from PED presentation
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