Patient discussions

​Parents and caregivers of children who are managed as outpatients can be given advice on management of fever with antipyretics and prevention of dehydration. Provision of safety-netting advice is also important, including how to identify any signs of deterioration and where to access further medical assessment if they occur.[9]​ Advise caregivers to bring the child for reassessment if any of the following features is present:​[3][9]​​​[15]​​

  • A high swinging or persistent fever that continues >48 hours after antibiotic treatment has started.

  • Any signs of harder work of breathing, such as a fast respiratory rate or chest recession.

  • Breathing makes the child agitated and distressed.

  • Unresolved fatigue.

  • Reduced fluid intake or poor feeding.

  • Symptoms do not start to improve within 3 days.

Any child who does not show signs of improvement within 48-72 hours of starting antibiotic therapy also needs reassessment.[1]

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