Temperature measurement occurs at more than one-half of well-child visits and may impact antibiotic prescribing and vaccine deferral, according to a study published in Pediatrics. Researchers analyzed well-child visits from 2014-2019. Temperature measurement occurred at 58.9% of 155,527 visits; 16 of 24 clinics measured temperature at more than 90% of visits (routine measurement clinics), while eight measured temperatures at less than 20% of visits (occasional measurement clinics). Antibiotic prescription was more common and diagnostic testing was less common at routine measurement clinics (adjusted ORs, 1.21 and 0.76, respectively) after adjustment for age, ethnicity, race, and insurance. Fever was detected at 0.2% of routine measurement clinic visits, of which 17.4% were classified as probable incidental fever. Compared with visits without fever, antibiotic prescription and diagnostic testing were more common at visits with probable incidental fever (7.4% vs 1.7% and 14.8% vs 1.2%, respectively); vaccines were deferred at 50% of these visits. Routine temperature measurements “… have the potential for harm when incidental fever is detected,” the authors of an accompanying editorial wrote.
