Rochester protocol

<p id="H5">Rochester protocol&#160;—&#160;Another group attempted to identify low-risk febrile infants (defined as a rectal temperature greater than or equal to 38.0ºC or 100.4ºF) younger than 60 days. This schema utilized the following criteria:

&#160;</p>

<ul >

<li>≥37 weeks gestation, and hospitalized no longer than the mother</li>

<li>Infant was previously healthy</li>

<li>Infant was well-appearing, with no ear, soft tissue, or bone infections</li>

</ul>

<p>&#160;

Laboratory criteria were as follows:

&#160;</p>

<ul >

<li>WBC 5,000 to 15,000/microL with an absolute band count &#60;1,500/microL</li>

<li>Urinalysis with &#60;10 WBC/hpf and no bacteria seen</li>

<li>Stool with &#60;5 WBC/hpf if obtained</li>

</ul>

<p>&#160;

High-risk infants were hospitalized with empiric antibiotics, and low-risk patients were sent home without antibiotics but with reliable follow-up.

Of the 931 well-appearing infants, 437 (47 percent) were classified as low risk. Only five low-risk infants had an SBI with a negative predictive value of 98.9 percent (95% CI 97-100 percent). Although there was no consistent empiric treatment with antibiotics, there were no adverse outcomes, lending support to the consideration of less aggressive therapy in low-risk infants.</p>