title: Using the Rochester criteria to evaluate infantile fever is more effective in males than females.
abstract: OBJECTIVE
  The reliability of low-risk and high-risk criteria in evaluating febrile infants aged up to 60 days has been well documented. The aim of this study was to evaluate gender differences in the reliability of these criteria in order to exclude serious bacterial infection (SBI) in febrile infants.
  
  
  METHODS
  This study used the Rochester risk criteria, the study group was divided into low- or high-risk status for SBI, and the data were stratified by gender. SBI was defined as a urinary tract infection, bacteraemia, meningitis or bacterial enteritis.
  
  
  RESULTS
  We enrolled 1896 infants (58.3% males), and SBIs were found in 10.6% of the males and 8% of the females (p = 0.21). The sensitivity of the risk criteria was 91.5% for the males and 73.4% (p < 0.05) for the females, and the positive likelihood ratio was 2.64 in the males versus 2.14 in the females (p < 0.001). A multivariable analysis showed that high-risk male patients were more than two times more likely to develop a bacterial infection than high-risk females.
  
  
  CONCLUSIONS
  The Rochester risk criteria had a significantly higher sensitivity and positive likelihood ratio in males. Our findings suggest that clinicians should take gender into account when evaluating febrile infants.
authors.affiliation: Department of Pediatrics C, Schneider Children's Medical Center, Petach Tiqva, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Miri
authors.initials: M
authors.lastname: Dotan
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.|Department of Pediatrics B, Schneider Children's Medical Center, Petach Tiqva, Israel.
authors.forename: Liat
authors.initials: L
authors.lastname: Ashkenazi-Hoffnung
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.|Department of Pediatrics A, Schneider Children's Medical Center, Petach Tiqva, Israel.
authors.forename: Havazelet
authors.initials: H
authors.lastname: Yarden-Bilavsky
authors.affiliation: Department of Pediatrics C, Schneider Children's Medical Center, Petach Tiqva, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Jacob
authors.initials: J
authors.lastname: Amir
authors.affiliation: Department of Pediatrics A, Schneider Children's Medical Center, Petach Tiqva, Israel.
authors.forename: Naama
authors.initials: N
authors.lastname: Tirosh
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.|Unit of Emergency Medicine, Schneider Children's Medical Center, Petach Tiqva, Israel.
authors.forename: Meirav
authors.initials: M
authors.lastname: Mor
authors.affiliation: Department of Pediatrics C, Schneider Children's Medical Center, Petach Tiqva, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Efraim
authors.initials: E
authors.lastname: Bilavsky
mesh_terms: D005260:Female; D005334:Fever / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012737:Sex Factors
keywords: Bacteraemia; Neonatal fever; Rochester criteria; Sepsis work-up; Serious bacterial infection