It is not yet known how antibiotics may affect Serious Bacterial Infections (SBI). Our aim is to describe the presentation, management, and serious bacterial infections (SBI) of febrile children on or off antibiotics. Retrospective, cohort study of febrile Emergency Department patients, 0–36 months of age, at a single institution, between 2009and 2012. Seven hundred fifty-three patients were included: 584 in the No-Antibiotics group and 169 (22%) in the Antibiotics group. Age and abnormal lung sounds were predictors for being on antibiotics (OR 2.00 [95% CI 1.23–3.25] and OR 1.04 [95% CI 1.02–1.06] respectively) while female gender, and lower temperatures were negative predictors (OR 0.68 [95%0.47–0.98] and OR 0.47 [95% CI 0.32–0.67] respectively). Antibiotics were prescribed by a physician 89% of the time; the most common one being Amoxicillin/Clavulanic Acid (39%). The antibiotic group got more blood tests (57% vs 45%) and Chest X-Rays (37% vs 25%). Overall, the percent of SBIs (and pneumonias) was statistically the same in both groups (6.5% in the No-antibiotic group VS 3.6%). Children presenting on antibiotics and off antibiotics were significantly different in their presentation and management, although the overall percentages of SBI were similar in each group. Further investigations into this subgroup of febrile children are needed.

中文翻译：

---

比较急需使用抗生素的发热儿童：一项回顾性队列研究

尚不清楚抗生素如何影响严重细菌感染（SBI）。我们的目的是描述使用或禁用抗生素的高热儿童的表现，治疗和严重细菌感染（SBI）。在2009年至2012年之间，对单个机构的0-36个月大的发热急诊科患者进行了回顾性队列研究。其中包括753例患者：无抗生素组584例，非抗生素组169例（22％）。抗生素组。年龄和异常肺音是使用抗生素的预测指标（分别为OR 2.00 [95％CI 1.23–3.25]和OR 1.04 [95％CI 1.02–1.06]），而女性和体温较低则为阴性预测指标（OR 0.68 [95] ％0.47–0.98]和OR 0.47 [95％CI 0.32–0.67]。89％的时间由医生开抗生素处方；最常见的是阿莫西林/克拉维酸（39％）。抗生素组的血液检查较多（57％比45％）和胸部X光检查（37％比25％）。总体而言，两组的SBI（和肺炎）百分比在统计学上均相同（非抗生素组为6.5％，VS 3.6％）。尽管每组中SBI的总体百分比相似，但使用抗生素和不使用抗生素的儿童的表现和治疗方法差异很大。需要对该发热儿童亚组进行进一步调查。尽管每组中SBI的总体百分比相似，但使用抗生素和不使用抗生素的儿童的表现和治疗方式存在显着差异。需要对该发热儿童亚组进行进一步调查。尽管每组中SBI的总体百分比相似，但使用抗生素和不使用抗生素的儿童的表现和治疗方式存在显着差异。需要对该发热儿童亚组进行进一步调查。