To determine whether a Pediatric Critical Care team has an evolution of medical practice that decreases the utilization of diagnostic tests and consults, we examined the records of 69 patients admitted for meningitis or meningoencephalitis at Women and Children's Hospital in Charleston, W.Va., a university-affiliated, teaching hospital. The study was conducted from August 1990 to August 1994. We found that utilization of diagnostic resources (UDR) decreased over the four years, and there was a direct relationship between an increase in severity of illness and an increase in UDR. When adjusted per severity of illness, UDR decreased by $423 per year. The presence of a consult was a factor leading to an increase in resources, which were associated with an increased utilization of diagnostic tests and length of stay. The consultation rate was independent of the severity of illness and experienced a decrease over the years.