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Primum non Nocere Revisited

KENNETH B. ROBERTS, MD

Am J Dis Child. 1983;137(12):1143-1144.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The difficulty in diagnosing bacterial sepsis in newborns by clinical examination has long been recognized and emphasized.¹ Fever in neonates is of great concern and, operationally in most nurseries, is regarded as indicative of infection, warranting evaluation (a "sepsis workup") and treatment.^1,2

However, until the last decade, the literature contained little consideration of the appropriate management of a febrile infant who is old enough to be discharged from the hospital but still very young, in the first weeks of life. The prevailing policy in most university centers seemed to be routine hospitalization of febrile "neonates" and antibiotic treatment after culturing CSF, blood, and urine.³ This bias, extrapolated from nursery experience, was reinforced by McCarthy and Dolan⁴; they reviewed the records of 22 infants, 3 months of age or younger, with a temperature of 40 °C (104 °F) or higher and reported the "serious implications" of such . . . [Full Text PDF of this Article]

Author Affiliations
Departments of Pediatrics Sinai Hospital of Baltimore Baltimore, MD 21215

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