Outcome of Empiric Antibiotic Therapy in Febrile Children: Cross Sectional Study Conducted in Al Khansaa Teaching Hospital

Background: Fever is one of the most common presenting complaints in pediatric practice and is frequently managed with empiric antibiotic therapy, particularly in resource-limited settings where diagnostic uncertainty persists. Objectives: To evaluate the clinical outcomes of empiric antibiotic therapy in febrile children. Methods: This hospital-based cross-sectional study was conducted at Al-Khansaa Teaching Hospital, Mosul, Iraq, from March 2025 to February 2026. A total of 250 children aged ≤14 years presenting with fever (≥38°C) and receiving empiric antibiotic therapy were included. Demographic, clinical, laboratory, treatment, and outcome data were collected and analyzed using appropriate statistical tests. Results: The mean age was 36.2 ± 28.5 months, with a male predominance (56.4%). The majority of patients were aged 12–59 months (43.6%). Fever was present in 100% of cases, followed by cough (50.8%), poor feeding (40.8%), vomiting (36.4%), and diarrhea (30.8%). Leukocytosis was observed in 53.3% of tested patients, while 67.7% had positive C-reactive protein. Ceftriaxone was the most commonly prescribed antibiotic (48%), followed by ampicillin plus gentamicin (24.4%) and amoxicillin–clavulanate (15.6%). Clinical improvement within three days was achieved in 70.4% of patients, whereas 17.6% showed delayed improvement and 12% experienced treatment failure. The mortality rate was 3.2%. Conclusion: Empiric antibiotic therapy in febrile children produced generally positive short-term outcomes; however, the high rate of antibiotic use, as well as the presence of treatment failure and mortality, indicate the need for improved diagnostic tools and antimicrobial stewardship.