{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T08:37:06Z","timestamp":1792831026282,"version":"4.5.0"},"reference-count":33,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:00:00Z","timestamp":1792800000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:00:00Z","timestamp":1792800000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Guidelines for neonates presenting to the emergency department (ED) with fever, including fever at home, recommend a full septic work\u2010up and prompt administration of parenteral antibiotics. However, compliance is unknown. We sought to determine rates of guideline compliance in this population, reasons for non\u2010compliance and rates and outcomes of serious bacterial infection (SBI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single\u2010centre retrospective cohort study of all neonates aged \u2264\u200928\u2009days presenting to the ED with documented fever \u200938\u00b0C. We extracted and analysed hospital data from an electronic medical record for guideline compliance, reasons for non\u2010compliance, rates of SBI, and clinical outcomes. Our primary outcome was the rate of guideline compliance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 475 patients, less than half (46.5%) of whom received guideline\u2010compliant care. The primary contributor to guideline non\u2010compliance was fever at home but no fever in the ED. Overall, 65\/475 (15%) of patients had SBI, the majority of which were urinary tract infections (UTIs). 42\/65 (64.6%) of patients with SBI had a confirmed concurrent viral infection. 107\/475 (22.5%) were discharged home from ED, only one (0.9%) of whom was readmitted within 72\u2009h.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Fewer than half of febrile neonates presenting to the ED receive guideline\u2010compliant care, with the lowest compliance in infants who are febrile at home but not in the ED. Rates of SBI are high, and viral\u2010bacterial co\u2010infection is common. In some low\u2010risk infants, a tailored approach to investigation and management may be suitable, though risk mitigation strategies and potential future guideline adaptation warrant further exploration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jpc.70631","type":"journal-article","created":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T07:51:47Z","timestamp":1792828307000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Investigation and Management of Neonates Presenting to Hospital With Fever: A Retrospective Cohort Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0115-0516","authenticated-orcid":false,"given":"Patrick J. B.","family":"Walker","sequence":"first","affiliation":[{"name":"Department of Paediatrics The University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7630-5941","authenticated-orcid":false,"given":"Mike","family":"Starr","sequence":"additional","affiliation":[{"name":"Department of Paediatrics The University of Melbourne  Parkville Victoria Australia"},{"name":"Department of Emergency Medicine The Royal Children's Hospital Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1842-6854","authenticated-orcid":false,"given":"Sandy M.","family":"Hopper","sequence":"additional","affiliation":[{"name":"Department of Paediatrics The University of Melbourne  Parkville Victoria Australia"},{"name":"Department of Emergency Medicine The Royal Children's Hospital Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0225-7953","authenticated-orcid":false,"given":"Elliot","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine The Royal Children's Hospital Melbourne  Parkville Victoria Australia"},{"name":"Department of Critical Care The University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.ajem.2024.10.041","article-title":"Neonatal Presentations in the Pediatric Emergency Department: A Decade\u2010Long Retrospective Analysis","volume":"87","author":"Rhinehart B.","year":"2025","journal-title":"American Journal of Emergency Medicine"},{"issue":"3","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.cpem.2008.06.005","article-title":"Neonatal Sepsis in the Emergency Department","volume":"9","author":"Robinson D. 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L.","year":"2014","journal-title":"Critical Care Medicine"}],"container-title":["Journal of Paediatrics and Child Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.70631","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jpc.70631","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.70631","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T07:51:51Z","timestamp":1792828311000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jpc.70631"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,24]]},"references-count":33,"alternative-id":["10.1111\/jpc.70631"],"URL":"https:\/\/doi.org\/10.1111\/jpc.70631","archive":["Portico"],"relation":{},"ISSN":["1034-4810","1440-1754"],"issn-type":[{"value":"1034-4810","type":"print"},{"value":"1440-1754","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,24]]},"assertion":[{"value":"2026-09-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jpc.70631"}}