Clinical and consumer guidelines related to the management of childhood fever

Abstract

Background: The majority of childhood fever episodes are considered part of normal childhood development. However, febrile children frequently present to hospital and general practitioners. Health providers and parents therefore require knowledge on how to manage childhood fever, how to recognise which febrile children are likely to become seriously ill and when to seek urgent medical advice. This information is frequently provided in the form of clinical and/or consumer guidelines. Aim: The aim of this systematic review was to identify and assess clinical and consumer guidelines related to the management of childhood fever. Methods: A comprehensive search strategy included searching electronic clinical databases, guideline databases, Internet searching, contacting paediatric hospitals across the UK, and experts and researchers. Application of inclusion criteria, quality assessment and data extraction were independently conducted by two reviewers. Data is presented in tabular format with narrative discussion. Results: A total of 22 guidelines were identified and included in the review. Five were clinical guidelines and 17 guidelines designed for parents/carers. The results highlight that key markers cannot be identified to help predict which febrile children might become seriously ill. Because childhood fever guidelines also lack comprehensive evidence and offer conflicting recommendations, parents and carers are unlikely to be able to identify such markers. Conclusions: Current clinical and consumer guidelines related to childhood fever are not evidence-based and appear to be produced as consensus statements summarising current care provision. Healthcare workers need to ensure when undertaking the development and dissemination of patient information that they follow appropriate processes to incorporate the most appropriate evidence. Current guidelines fail to provide information on key markers to enable early recognition of seriously ill children. This review also demonstrates that alternative search strategies can prove effective in identifying guidelines for care.