| Boston criteria | Milwaukee criteria | Philadelphia criteria | Rochester criteria |
Age range | | | | |
Temperature | | | | |
History* | - No immunizations within last 48 hours
- No antimicrobial within 48 hours
- Not dehydrated
| | | - Term infant
- No perinatal antibiotics
- No underlying disease
- Not hospitalized longer than the mother
|
Physical examination* | - Well appearing
- No sign of focal infection (middle ear, soft tissue, bone/joint)
| - Well appearing (normal breathing, alert, active, normal muscle tone)
- Not dehydrated
- No sign of focal infection (middle ear, soft tissue, bone/joint)
| - Well appearing
- Unremarkable examination
| - Well appearing
- No sign of focal infection (middle ear, soft tissue, bone/joint)
|
Laboratory parameters* | - CSF <10/mm3
- WBC <20,000/mm3
- UA <10 WBCs/hpf
- Chest radiograph: no infiltrate (if obtained)
| - CSF <10/mm3
- WBC <15,000/mm3
- UA <5 to 10 WBCs/hpf (no bacteria, negative LE/nitrite)
- Chest radiograph: no infiltrate (if obtained)
| - CSF <8/mm3
- WBC <15,000/mm3
- UA <10 WBCs/hpf
- Urine Gram stain negative
- CSF Gram stain negative
- Chest radiograph: no infiltrate
- Stool: no blood, few or no WBCs on smear (if indicated)
- Band-neutrophil ratio <0.2
| - CSF: NA (no lumbar puncture is indicated)
- WBC >5000 and <15,000/mm3
- ABC <1500
- UA ≤10 WBCs/hpf
- Stool: ≤5 WBCs/hpf smear (if indicated)
|
Management strategy for low risk | - Home/outpatient
- Empiric antibiotics
- Follow-up required
| - Reliable caretaker followup required
- IM ceftriaxone 50 mg/kg followed by re-evaluation within 24 hours
| - Home/outpatient
- No antibiotics
- Followup required
| - Home/outpatient
- No antibiotics
- Follow-up required
|
Management strategy for high risk | - Hospitalize
- Empiric antibiotics
| | - Hospitalize
- Empiric antibiotics
| - Hospitalize
- Empiric antibiotics
|