A new study finds that babies and toddlers who arrive at the emergency room (ER) with an unexplained fever often receive no kind of diagnostic test to reveal the source of the high temperature. No diagnostic tests were ordered in 59% of the cases where a child aged three months to three years had a fever of unknown cause while urine tests and blood tests were conducted in 17% and 20% of cases, respectively. Prescribing antibiotics without testing to confirm the presence of a bacterial infection can potentially lead to antibiotic overuse. ER doctors prescribed antibiotics ~25% of the time, including for 20% of the fevers where no diagnostic test was performed. These results are consistent with past studies that have pointed to antibiotic overuse. Dr. Alan Simon, lead researcher, said that there is no universal advice to give parents on whether their feverish child should get a diagnostic test. “There are particulars of each case that would sway any one practitioner’s decision,” and the broader question is whether more testing, or less testing, would actually improve children’s care. “We don’t know yet if changes in current practice would lead to better outcomes.” Pediatrics. 2011 Nov 21. PMID: 22106081
