Clinical Pattern of Viral Fever in Children: Is Rational Antibiotic Use Possible in Non-Critical Hospitalized Children in Resource Limited Setting?

Abstract

Introduction: Most of Viral infections in non-critical children are self-limiting. Yet, many times, due to lack of clinical knowledge, antibiotics are prescribed which leads to antimicrobial resistance. Aim is to study the demographic and clinical profile and outcome in non-critical children admitted with suspected viral infection. Materials and method: It was a prospective observational study carried out in the pediatric ward of Shardaben Hospital between November 2014 and August 2015. Results: Out of the total 3143 patients, 1760(56%) were non-critical with suspected viral infection on admission. The fever was regular in 89% patients, while 88% patients got better on 3rd day of admission. 82% children were not sick in the inter-febrile period. The fever was high grade at onset in 75% patients and 91% responded to paracetamol. In 4.6% of patients fever found to be non-viral but none of the patients required PICU care. There was no mortality. Conclusion: Viral fever is usually high grade at onset, with non-sick inter-febrile period and natural improvement by 3rd or 4th day of illness. With these clues, viral infection can be suspected and antibiotic misuse can be avoided even in hospitalized children.

Keywords

• Rational antibiotic use
• viral fever
• antimicrobial resistance
• non-critical