Fever in children – new draft guidance

NICE has issued updated draft guidance on assessing fever in children under five.

The guideline retains the bulk of the original 2007 recommendations, including that children with feverish illness should be assessed using the traffic light system tool. But a number of new recommendations have been added taking account of new evidence about the relationship of heart rate to fever in predicting the risk of serious illness.

The guidance also assesses the clinical and cost-effectiveness of combination or alternating therapy with paracetamol and ibuprofen in the management of childhood fever and, for the first time, includes a summary table for symptoms and signs suggestive of specific diseases such as meningitis and pneumonia.

Professor Mark Baker, Director of the Centre for Clinical Practice at NICE, said: "There is still evidence that the management of young children presenting with fever varies across the UK and that this continues to have an impact on outcomes.

"Updating the NICE guideline to take into account new evidence will ensure that it remains current and relevant. Not all children will need to be taken to hospital and this guideline will help doctors, nurses, pharmacists and other healthcare professionals to pick up the high-risk symptoms that indicate a child needs urgent medical attention. It will also help to empower parents so they can work in partnership with healthcare professionals to care for children with a feverish illness."

The consultation on Feverish illness in children ends on 11 January 2013. NICE expects to publish final guidance for the NHS in May 2013.