For infants less than 28 days old with a fever at or above 38°C, what is the recommended treatment?

For infants less than 28 days old presenting with a fever at or above 38°C, the recommended treatment is to admit them to the hospital for further evaluation. This approach is guided by the increased risk of serious bacterial infections in very young infants, such as meningitis, sepsis, or other infections that can be life-threatening.

Due to the immaturity of the immune system in neonates, even a fever can signal a potentially severe underlying condition. Hence, hospital admission allows for comprehensive evaluation, including laboratory tests like blood cultures, urinalysis, and, if indicated, lumbar puncture to assess for meningitis. Additionally, immediate intravenous antibiotics may be initiated to provide timely treatment while awaiting diagnostic results.

Other options, such as outpatient care or observation, would not provide the necessary level of monitoring and immediate intervention needed for such a vulnerable population, increasing the risk of poor outcomes. The hospitalization not only ensures close observation but also guarantees access to necessary interventions that can be critical in this age group.