New fever in adults in the intensive care unit: current insights from the 2024 Society of Critical Care Medicine and Infectious Diseases Society of America guidelines.

Abstract

Fever is among the most frequent clinical signs encountered in the intensive care unit. It often triggers broad diagnostic evaluation and empiric treatment, with implications for patient outcomes and resource use. The 2024 joint guidelines from the Society of Critical Care Medicine and the Infectious Diseases Society of America offer updated, evidence-based recommendations for the evaluation of new-onset fever in adults in the intensive care unit. Replacing the 2008 guideline, this iteration integrates advances in diagnostic methods, a structured guideline development process, and renewed emphasis on antimicrobial stewardship. The panel issued one strong recommendation, 12 weak recommendations, nine best practice statements, and identified four areas where no recommendation was feasible. This review distills the guideline's most relevant insights, clarifies points of uncertainty, and presents a practical framework for applying its recommendations at the bedside.