title: Duration of fever and serious bacterial infections in children: a systematic review.
abstract: BACKGROUND
  Parents of febrile children frequently contact primary care. Longer duration of fever has been related to increased risk for serious bacterial infections (SBI). However, the evidence for this association remains controversial. We assessed the predictive value of duration of fever for SBI.
  
  
  METHODS
  Studies from MEDLINE, Embase and Cochrane databases (from January 1991 to December 2009) were retrieved. We included studies describing children aged 2 months to 6 years in countries with high Haemophilus influenzae type b vaccination coverage. Duration of fever had to be studied as a predictor for serious bacterial infections.
  
  
  RESULTS
  Seven studies assessed the association between duration of fever and serious bacterial infections; three of these found a relationship.
  
  
  CONCLUSIONS
  The predictive value of duration of fever for identifying serious bacterial infections in children remains inconclusive. None of these seven studies was performed in primary care. Studies evaluating the duration of fever and its predictive value in children in primary care are required.
authors.affiliation: Erasmus MC, Department of General Practice, PO Box 2040, 3000 CA Rotterdam, The Netherlands. g.elshout@erasmusmc.nl
authors.forename: Gijs
authors.initials: G
authors.lastname: Elshout
authors.forename: Miriam
authors.initials: M
authors.lastname: Monteny
authors.forename: Johannes C
authors.initials: JC
authors.lastname: van der Wouden
authors.forename: Bart W
authors.initials: BW
authors.lastname: Koes
authors.forename: Marjolein Y
authors.initials: MY
authors.lastname: Berger
mesh_terms: D001424:Bacterial Infections / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D005334:Fever / Q000382:microbiology*; D006801:Humans; D007223:Infant; D011237:Predictive Value of Tests; D013997:Time Factors