TABLE 3 The Three Most Common Strategies for Managing Febrile Infants Philadelphia Criteria7 Rochester Criteria9 Boston Criteria8 Age 29-60 d 60 d 28-89 d Temperature 38.2°C 38.0°C 38.0°C History Not specified   Term infant    No immunizations within preceding 48 h   No perinatal antibotics   No underlying disease   No antimicrobial within 48 h   Not hospitalized longer than the mother   Not dehydrated Physical examination   Well-appearing   Well-appearing   Well-appearing   Unremarkable examination   No ear, soft tissue, or bone infection   No ear, soft tissue, or bone infection Laboratory parameters (defines lower risk patients)   WBC <15 000/mm3   Band-neutrophil ratio <0.2   UA <10 WBC/hpf   Urine Gram stain negative   CSF <8 WBC/mm3   CSF Gram stain negative   Chest radiograph: no infiltratea   Stool: no blood, few or no WBCs on smearb   WBC >5000 and <15 000/mm3   Absolute band count <1500/mm3   UA 10 WBC/hpf   5 WBC/hpf stool smearb   CSF <10/mm3   UA <10 WBC/hpf   Chest radiograph: no infiltratea   WBC <20 000/mm3 Higher risk patients Hospitalize + empiric antibiotics Hospitalize + empiric antibiotics Hospitalize + empiric antibiotics Lower risk patients   Home   Home   Home   No antibiotics   No antibiotics   Empiric antibiotics   Follow-up required   Follow-up required   Follow-up required Reported statistics Sensitivity 98% (92 100) Sensitivity 92% (83-97%) Sensitivitynot available Specificity 42% (38-46%) Specificity 50% (47-53%) Specificity 94.6% Positive predictive value 14% (11-17%) Positive predictive value 12.3% (10-16%) Positive predictive value not available NPV 99.7% (98-100%) NPV 98.9% (97-100%) NPVnot available a If obtained. b If indicated.