Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

Serious bacterial infections in infants under 2-years-of-age with fever without a source remains, despite advances in vaccination, a matter of concern for both physicians and parents. Having cost-effectiveness information is relevant to guide decision making in clinical practice in this scenario. Objective: To determine the cost-effectiveness of four different strategies of screening in Argentina for serious bacterial infection in children presenting with fever without a source. Materials and methods: We designed a decision tree to model a hypothetical cohort of 10,000 children with fever without a source. We compared the incremental cost-effectiveness of four strategies to detect serious bacterial infection: Rochester criteria + C reactive protein test, Rochester criteria + procalcitonin test, Rochester criteria, and expectant observation. Results: Rochester criteria + C reactive protein test was the most cost-effective strategy with USD$ 784 for each correctly diagnosed case versus USD$ 839 of Rochester criteria + procalcitonin test, USD$ 1,116 of expectant observation or USD$ 1,193 of Rochester criteria. When the probability of serious bacterial infections was equal or less than 14%, the strategy of choice was expectant observation. Conclusions: The Rochester criteria + C reactive protein test was the most cost-effective strategy to detect serious bacterial infection in one to three months old children with fever without a source. However, in low risk settings for such infection, the strategy of choice is expectant observation.

Original publication






Publication Date





406 - 414


Bacterial infections/diagnosis, cost-benefit analysis, fever, infant, Argentina, Bacterial Infections, Cost-Benefit Analysis, Fever, Humans, Infant, Risk