The Pediatric infectious disease journal
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Pediatr. Infect. Dis. J. · Oct 2011
Rapid increase in use of antiviral therapy for hospitalized children with influenza during the 2009 H1N1 epidemic.
We used the Pediatric Health Information System to examine annual trends in antiviral prescribing for hospitalized children with influenza before and during the 2009 H1N1 epidemic. During the 2009 H1N1 epidemic, the Centers for Disease Control and Prevention issued recommendations advising antiviral therapy for all hospitalized patients with influenza infection. Before the 2009 H1N1 outbreak, antivirals were prescribed for only 28% of hospitalized children with influenza. This increased sharply to 84% during the 2009 H1N1 period, indicating a favorable response by physicians to clinical guidelines.
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Lack of agreed-upon diagnostic criteria for acute otitis media (AOM) has led to inconsistencies in clinical care, misleading research results, and misguided educational efforts. The objective of this study was to examine findings that expert otoscopists use when diagnosing AOM. ⋯ We describe findings that are used by experienced otoscopists to diagnose AOM and OME. The findings point to the advisability under most circumstances of restricting antimicrobial treatment for AOM to children who have TM bulging, and they call into question clinical trials of the treatment of AOM in which TM bulging has not been a required element for participation.
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Pediatr. Infect. Dis. J. · Oct 2011
The use of blood counts and blood cultures to screen neonates born to partially treated group B Streptococcus-carrier mothers for early-onset sepsis: is it justified?
No clear recommendations exist regarding the approach to evaluate neonates born to partially treated group B Streptococcus (GBS)-carrier mothers for early-onset GBS (EO-GBS) sepsis. ⋯ The use of CBC and blood culture to screen neonates born to GBS-carrier mothers who received only one dose of IV antibiotic before delivery led to a negligible clinical yield and a high rate of technical failure. Although these findings are in line with the recent change in the Centers for Disease Control guidelines, they put in question the cost of this practice in terms of neonatal pain and parental anxiety.
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Pediatr. Infect. Dis. J. · Oct 2011
Treatment of Kaposi sarcoma in human immunodeficiency virus-1-infected Mozambican children with antiretroviral drugs and chemotherapy.
AIDS-associated Kaposi sarcoma occurs in children, but treatment experience reports are very scarce. A retrospective analysis of 28 children treated with highly active antiretroviral therapy and monthly paclitaxel showed unexpected results with 19 children in complete and sustainable remission, including those with the most severe form. Tolerance and feasibility were good, despite a lack of skilled staff in a low-resource setting.