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Evidence of Poor Utility of Current Sepsis Screening Tools in an At-risk Population of Children With Community-Acquired Pneumonia

Damian Roland,W. Stohr,Diana Gibb,K. Sturgeon,J. Bielicki,M. Lyttle

Published 2025 in The Pediatric Infectious Disease Journal

ABSTRACT

Background: Children (6–24 kg) with lower respiratory tract infections were prospectively recruited in emergency departments to high or low doses of oral amoxicillin. We identified children who met the criteria for medium and high risks of sepsis, as per the UK’s National Institute for Health and Care Excellence (NICE). Of those able to be discharged with oral antibiotics; 54% (318/591) had high-risk sepsis criteria. NICE sepsis guidance is poorly specific, with implications for antimicrobial resistance and iatrogenic patient harm. Methods: Children (6–24 kg) with lower respiratory tract infections were prospectively recruited in emergency departments to high or low doses of oral amoxicillin. Results: Of those able to be discharged with oral antibiotics, 54% (318/591) had high-risk sepsis criteria as per the UK’s NICE. Conclusions: NICE sepsis guidance is poorly specific, with implications for antimicrobial resistance and iatrogenic patient harm.

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