TABLE 3

Hospital-Level Variation in the Management and Outcomes of Febrile Young Infants Across 37 Pediatric EDs

Overall Median (IQR)a≤28 d Median (IQR)a29–56 d Median (IQR)a57–89 d Median (IQR)a
Testingb
 Laboratory testingc
  Urine+Blood+CSF43.0 (33.8–49.6)72.0 (66.2–76.5)47.2 (38.5–58.8)11.8 (8.1–19.0)
  Urine+Blood26.4 (21.8–33.5)5.8 (4.4–9.3)25.0 (20.0–34.3)39.9 (34.6–47.9)
  Urine only5.4 (3.0–8.1)0.9 (0.7–2.0)2.3 (1.6–4.7)12.6 (5.8–19.0)
  Other combinations of Urine, Blood, CSF5.6 (4.3–6.8)4.8 (3.6–6.6)5.0 (4.0–7.1)6.2 (5.2–7.5)
  None18.2 (13.7–22.9)14.6 (9.1–18.7)14.8 (10.3–18.5)23.5 (19.7–30.8)
 Radiographic testing
  Chest radiograph27.0 (19.4–34.1)25.9 (20.0–33.1)26.6 (19.6–37.1)25.3 (16.7–33.0)
Treatmentb
 Hospitalizedd
  Ampicillin+third generation cephalosporin46.5 (33.8–54.2)71.0 (52.2–81.6)41.1 (23.4–53.8)11.1 (6.5–18.1)
  Ampicillin+gentamicin3.4 (1.3–9.8)6.3 (1.5–15.3)0 (0–3.2)0 (0–0)
  Ampicillin+gentamicin+third generation cephalosporin2.9 (1.1–5.1)4.3 (1.9–8.4)1.6 (0.5–3.8)0 (0–0.8)
  Third generation cephalosporin alone22.1 (13.3–26.4)0.6 (0–1.1)30.3 (15.7–46.2)50 (33.3–57.3)
  Other IV or IM antibiotic combination9.4 (7.3–12.1)7.2 (5.0–9.9)8.7 (6.3–13.1)15.2 (10.0–22.7)
  No IV or IM antibiotics10.9 (8.2–14.2)4.6 (3.5–7.1)12.4 (8.8–17.4)20.7 (14.8–29.5)
  Acyclovir16.5 (10.5–24.3)25.6 (16.8–39.8)9.5 (6.5–17.1)4.2 (1.9–6.1)
 Discharged from the EDe
  Ceftriaxone12.0 (7.6–21.1)0 (0–2.0)15.7 (7.1–25.7)12.0 (7.8–19.9)
  Other IV or IM antibiotic0.8 (0.3–1.2)0.8 (0–3.7)0.6 (0–1.7)0 (0–0.5)
  No IV or IM antibiotics87.5 (78.5–91.6)97.0 (94.4–100.0)83.9 (72.8–91.8)87.4 (79.1–91.8)
Disposition
 Hospitalized39.0 (35.1–50.8)78.4 (74.3–83.8)45.1 (35.9–53.0)14.9 (9.6–22.9)
Outcomes
 SBIf7.5 (6.0–10.1)10.5 (7.9–13.8)6.8 (5.1–8.4)6.8 (5.0–9.9)
 3-d revisitse5.3 (4.7–6.1)2.4 (1.0–3.4)5.7 (4.6–7.1)6.7 (5.3–8.2)
 3-d revisits resulting in hospitalizatione1.8 (1.3–2.3)1.6 (0.8–2.7)1.8 (1.3–2.6)1.1 (0.8–2.2)
  • CXR, chest radiograph; IV, intravenous; IM, intramuscular.

  • a Median proportion of patients who underwent each type of testing and treatment at the 37 pediatric EDs.

  • b Testing or treatment performed on Day 0 or 1 of hospitalization.

  • c Urine testing defined as urine dipstick, urinalysis or urine culture; blood testing as CBC or blood culture; CSF testing as cell count,

  • culture, or lumbar puncture.

  • d Percentage among hospitalized patients.

  • e Percentage among discharged patients.

  • f UTI or pyelonephritis, bacteremia or sepsis, bacterial meningitis, pneumonia, bacterial enteritis.