The management of fever in young infants aged <2 months has been a subject of interest for many years. In the mid-1980s and early 1990s, investigators at university medical centers located in Rochester, Philadelphia, and Boston independently conducted large, rigorous investigations of the reliability of risk stratification parameters and safety of outpatient management of fever in selected low-risk febrile infants, with or without empiric antibiotic administration.1,3 Although these assessment protocols used many of the same parameters, they differed from each other in small but important ways. In particular, the Rochester criteria included infants <1 month old and did not mandate a lumbar puncture. All criteria have been shown to be highly reliable with a sensitivity of identifying infants who had serious bacterial illness of 92% to 99% and negative predictive values close to 100%. Thus, these strategies provided a fairly reliable means of identifying febrile infants...

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