Lack of agreement between tympanic and oral temperature measurements in adult hospitalized patients

Abstract

Background: The purpose of this study was to compare temperature measurements obtained by tympanic thermometers with those obtained by oral electronic or mercury-glass thermometers in adult hospitalized patients. Methods: A prospective study of 406 nonintensive care unit adult patients hospitalized during an 8-month period in a tertiary care community medical center. Results:Poor agreement was observed between tympanic versus electronic thermometer readings, with 95% limits of agreement of –2.11°F to +2.81°F. Similarly, poor agreement was observed between tympanic versus oral mercury-glass temperatures, with 95% limits of agreement of –1.72°F and +2.64°F. Of 27 oral electronic temperatures 100°F (37.7°C) or higher, 10 (37%, 95% confidence interval 19% to 58%) readings were 99.5°F (37.5°C) or lower, and six (22%, 95% confidence interval 9% to 42%) measured lower than 98.6°F by tympanic thermometers. Conclusions: Temperatures measured by tympanic thermometers generally have poor agreement with those measured by oral electronic or mercury-glass thermometers in adult hospitalized patients. We recommend that tympanic thermometers not be used for routine screening for fever in this patient population. (AJIC Am J Infect Control 1998;26:428-30)