The non-specific symptoms and signs of severe bacterial infection (SBI) in the neonate means that for reasons of safety many children with fever are hospitalised and treated with antibiotics for non-existent bacterial infections. Psychologists, microbiologists, parents and hospital managers have taught us that admission is something to be avoided, although for some families the perceived safety of a children’s ward can be very reassuring. Thus, a study that helps to discriminate the neonate with infection from one without infection is to be welcomed.

What have Marom et al¹ shown? There was an extremely low rate of SBI (1/166; 0.6%) among infants fulfilling low-risk criteria, as follows: previously well, good appearance, no focal signs, a low erythrocyte sedimentation rate, a white cell count of 5000–15 000/mm³ and normal urinalysis. The relatively high risk for SBI in the other group (107/220; 48.6%) was accounted for by a large number of children with urinary tract infections (n = 54) and with otitis media (n = 36); otitis media is regarded as relatively unusual in the neonate. In this study all infants were treated, but it was suggested that further research be performed with …