Raghavan VR, Porter JJ, Neuman MI, et al. - Analyzing trends in assessment and management of children with simple febrile seizures (SFSs) prior to and following the American Academy of Pediatrics updated guidelines published in 2011, a reduction in diagnostic testing, hospital admission, and costs was observed during the study span and there was no concomitant increment in delayed diagnosis of bacterial meningitis. Overall, most of the cases of SFSs in the pediatric population can be safely managed without lumber puncture or other diagnostic testing.

• The Pediatric Health Information System database was used in this retrospective, cross-sectional study including 142,121 children (median age 21 months, 42.4% female) with an emergency department visit for SFS.

• A reduction in the rate of lumbar puncture, from 11.6% in 2005 to 0.6% in 2019, was observed for all ages.

• Similar decreases were observed in rates of head computed tomography (10.6% to 1.6%), complete blood cell count (38.8% to 10.9%), hospital admission (19.2% to 5.2%), and mean costs ($1,523 to $601).

• Decreases in all outcomes commenced prior to, and continued following, the publication of the American Academy of Pediatrics guideline.