Unifying Concepts

Rochester Criteria for Identifying Febrile Infants at Low Risk for Serious Bacterial Infection

The Rochester criteria were developed to identify febrile infants aged 60 days or younger at low-risk of bacterial infection and do not include cerebrospinal fluid (CSF) testing.

1- Infant appears generally well

2- Infant has been previously healthy:

  • Born at term (>/=37 weeks of gestation)

  • No perinatal antimicrobial therapy

  • No treatment for unexplained hyperbilirubinemia

  • No previous antimicrobial therapy

  • No previous hospitalization

  • No chronic or underlying illness

  • Not hospitalized longer than mother

3- Infant has no evidence of skin, soft tissue, bone, joint or ear infection

4- Infant has these laboratory values:

  • White blood cell count of 5,000 to 15,000 per mm3 (5 to 15 x 109 per L)

  • Absolute band cell count of </=1,500 per mm3 (</=1.5 x 109 per L)

  • Ten or fewer white blood cells per high-power field on microscopic examination of urine

  • Five or fewer white blood cells per high-power field on microscopic examination of stool in infant with diarrhea



1. Jaskiewicz JA, McCarthy CA, Richardson AC, White KC, Fisher DJ, Dagan R, Powell KR. 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 Sep;94(3):390-6. [Medline]


Created: Jul 21, 2005

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