Febrile Children at a General Practice Out-of-hours Service

Childhood fever occurs frequently in young children and is a common reason for parents to contact a general practitioner (GP). On average children have suffered from 8 infective episodes at the age of 18 months. In an English birth cohort of 13,617 young children, parents have reported at least one episode with high temperature in up to 74% of the children during a follow-up period of 14 months. Most illnesses causing fever are self-limiting, however some children are at risk of developing serious infections that need medical treatment. After the introduction of vaccination programmes against Haemophilus influenzae and Streptococcus pneumoniae the incidence of serious infections is declining. The annual incidence of serious infections is now estimated to be around 1% in primary care.8 Although serious infections are rare in primary care, they may have serious consequences such as morbidity and mortality. In the English birth cohort parents consulted a physician in case of fever in up to 39% of all children within a period of one year. In addition, emergency admissions, mainly short-term admissions (less than one day), have increased in children aged under in England in the past decade. In another English study 34% of the febrile children with symptoms of a respiratory tract infection were prescribed antibiotics. Fever was found to be the main reason for contact in 21% of the children for whom a Swiss pediatric telephone triage and advice center was contacted during after-hours. So, childhood fever is a reason for parental concern, increasing healthcare use and substantial antibiotic prescription rates in young febrile children.