Empiric Antibiotics for the Complex Febrile Child: When, Why, and What to Use

There are multiple patient care scenarios where empiric antibiotics are indicated in the practice of pediatric emergency medicine. Patients with fever and neutropenia, ventriculoperitoneal shunt(s), cystic fibrosis, and short bowel syndrome are unique patient populations that are often instructed to seek further evaluation for any concerns of possible infection. When seen in the emergency department, fever is usually the presenting complaint; however, they may also present with more subtle signs and symptoms of infection that require prompt evaluation. This article briefly reviews these 4 unique patient populations as well as when, why, and what empiric antibiotics are often used to treat them.

Keywords: fever, neutropenia, emergency, chronic disease, cystic fibrosis, short bowel syndrome, ventriculoperitoneal shunt