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NICE guideline review: fever in under 5s: assessment and initial management (NG143)
  1. Siba Prosad Paul1,
  2. Prashant Karkala Kini1,
  3. Shiv Ratan Tibrewal2,
  4. Paul Anthony Heaton1
  1. 1Paediatrics, Yeovil District Hospital, Yeovil, UK
  2. 2Paediatrics, Darlington Memorial Hospital, Darlington, UK
  1. Correspondence to Dr Siba Prosad Paul, Paediatrics, Yeovil District Hospital, Yeovil BA21 4AT, UK; siba.paul{at}nhs.net

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Background

Feverish illness is one of the leading causes for a child to be seen by healthcare professionals, and is a major cause for hospital admissions.

In 2007, the National Institute for Health and Care Excellence (NICE) published the original guidance on feverish illness in children (CG47). This was developed to aid healthcare professionals in their decision-making process while managing children aged <5 years with fever. This guidance has been revised multiple times in 2013 (CG160) and 2019 (NG143) and was updated in 2017.

Information about the current guideline

The current update (NG143) has made specific recommendations on assessment for Kawasaki disease in febrile children.1 Most of the recommendations from the past update 2013 (CG160) have been retained.

This guideline should be used in conjunction with other NICE guidelines on gastroenteritis (CG84), urinary tract infection (CG54), neonatal infection (NG195), bacterial meningitis (CG102) and sepsis (NG51) (see box 1).

Box 1

Resources

  • Fever in under 5s: assessment and initial management (National Institute for Health and Care Excellence guideline 2019): https://www.nice.org.uk/guidance/ng143

  • Sepsis: recognition, diagnosis and early management (National Institute for Health and Care Excellence guideline 2016): https://www.nice.org.uk/guidance/ng51

  • Neonatal infection: antibiotics for prevention and treatment (National Institute for Health and Care Excellence guideline 2021): https://www.nice.org.uk/guidance/ng195

  • Meningitis (bacterial) and meningococcal septicaemia in under 16s: recognition, diagnosis and management (National Institute for Health and Care Excellence guideline 2010): https://www.nice.org.uk/guidance/cg102

  • Urinary tract infection in under 16s: diagnosis and management (National Institute for Health and Care Excellence guideline 2007): https://www.nice.org.uk/guidance/cg54

  • Diarrhoea and vomiting caused by gastroenteritis in under 5s: diagnosis and management (National Institute for Health and Care Excellence guideline 2009): https://www.nice.org.uk/Guidance/CG84

The incidence and type of serious bacterial infection is likely to have changed following the introduction of newer vaccines.2 3 This review encompasses recommendations from the NICE guideline NG143 (2019).

Key issues that the guideline addresses

Definition of fever

Children <3 months with temperature ≥38°C should be included in red …

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Footnotes

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

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