The best way to treat young infants with a fever isn't clear.
Young infants with a fever (under 3 months of age) represent a high-risk group for serious bacterial infection (urinary tract infection, bacteraemia, and meningitis). These young infants will undergo procedures such as blood and urine testing. They may also undergo invasive testing such as a lumbar puncture to identify those with a serious bacterial infection. Most young infants usually are admitted to hospital and treated with intravenous antibiotics. However, only a few will end up having a serious bacterial infection. The ideal approach to managing and treating these young infants with a fever isn’t clear as some of these infants will be at low risk obviating the need for invasive testing, antibiotics, and admission.
What is the FIDO study?
The FIDO (Febrile Infant Diagnostic assessment and Outcome) study aims to look at different diagnostic approaches and see which is best at identifying infants with a fever low and high-risk of serious bacterial infection. In addition, we intend to explore how new blood test called procalcitonin which could be used to enhance current clinical practice.
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How will this study be carried out?
We plan to recruit infants under 3 months of age presenting with a fever and suspected serious bacterial infection to the emergency department. All infants will get emergency clinical care as usual without delays.
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As the management of this young infants with a fever is time critical, we will use a method of delayed consent from the parents/guardians which is nationally accepted. During routine care and blood testing, some infants will have 1 ml of blood taken that will be saved for evaluating new blood tests. We will follow up these infants for seven days to see which of them develops serious bacterial infection. In some hospitals parents and doctors will be interviewed about how the communication of the risk and benefits of different approaches is undertaken. We will also look at the cost of various approaches and which would be most cost-effective for our population in UK and beyond. Our results will be published in scientific journals, presented at conferences, and used to inform future guidelines. This will shape how we manage infants 3 months and younger with a fever.
Who is leading the study?
Chief investigator - Dr Thomas Waterfield, Queen’s University Belfast
Doctoral Fellow - Dr Etimbuk Umana, Queen’s University Belfast
Sponsorship and Funding
Queen’s University Belfast is the FIDO study sponsor and the Royal College of Emergency Medicine has provided a Doctoral Fellowship as funding.