Rochester Criteria for Febrile Infants
Identifies febrile infants ≤ 60 days old (rectal temperature ≥ 38 °C) at low risk of serious bacterial infection (SBI). All 7 criteria must be met for 'low risk'.
Score interpretation
Meets all Rochester criteria — SBI in 1.1% (negative predictive value 98.9%, Jaskiewicz 1994).
→ Careful observation without antibiotics may be considered if reliable follow-up is available (Jaskiewicz 1994). Clinical judgement required — do not apply mechanically.
Does not meet all Rochester criteria — not low risk for serious bacterial infection.
→ Full septic workup (FBC, blood culture, LP, urinalysis and culture, CXR if respiratory symptoms); empiric IV antibiotics per local guidance; admit.
Interpretation bands for the Rochester Criteria. Apply clinical judgement and local guidance.
References
- Jaskiewicz JA et al. Febrile infants at low risk for serious bacterial infection — an appraisal of the Rochester criteria and implications for management. Febrile Infant Collaborative Study Group. Pediatrics. 1994;94(3):390–396.
Related
Curated clinical cross-links plus same-class fallbacks.
- Phenobarbital (Paediatric Epilepsy — Beyond Neonatal) · Barbiturate Anticonvulsant
- Paracetamol (Paediatric) · Analgesic / Antipyretic — First-Line Pain and Fever in Children
- Diazepam (Paediatric) · Benzodiazepine — Status Epilepticus / Febrile Convulsions (Community)
- Dexamethasone (Paediatric) · Corticosteroid — Croup / Bacterial Meningitis / Post-Extubation Stridor / Cerebral Oedema
- Gentamicin (Paediatric) · Aminoglycoside — Neonatal Sepsis / Gram-Negative Infections in Children
- Aciclovir (Paediatric) · Antiviral — HSV Encephalitis / Neonatal Herpes / VZV in Immunocompromised
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.
