It is also important to remember that after a decision is made to treat a child empirically with antibiotics, there is still the need for careful observation, whether that be in the hospital or by frequent outpatient contacts with the physician. Careful observational assessment and risk stratification, though not infallible, are very valuable tools that allow the family physician to accept varying degrees of uncertainty in clinical situations. The clinician's response to uncertainty is part of the philosophy and art of family practice and allows the clinician to instill confidence as the therapeutic process proceeds. Clinicians are eagerly awaiting further studies that more precisely define criteria for accurately assessing the risk of serious infection in the febrile child. For now, clinical observation and examination remain our most powerful tools.
Observation scales to identify serious illness in febrile children.
Dolan TF Jr. History and observation variables in assessing febrile children. McCarthy PL, Jekel JF, Stashwick CA, Spiesel SZ, Dolan TF Jr, Sharpe MR, et al. Further definition of history and observation variables in assessing febrile children. Jaskiewicz JA, McCarthy CA, Richardson AC, White KC, Fisher DR, Dagan R, et al. Febrile Infant Collaborative Study Group.