Arch Pediat Adol Med
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Arch Pediat Adol Med · Jun 1999
Determinants of counseling in primary care pediatric practice: physician attitudes about time, money, and health issues.
To assess pediatrician goals and practice in preventive counseling, and to use social learning theory to examine physician attitudes about preventive health issues, time, and reimbursement to explain physician counseling behavior. ⋯ Physician goals in child health supervision were primarily biomedical, with psychosocial and safety issues of lesser importance. Concern about time for preventive counseling was associated with less reported counseling. Physician attitudes regarding the importance of a health issue and their confidence and effectiveness in counseling were more predictive of physician practice than their attitudes about time and reimbursement for preventive care.
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Arch Pediat Adol Med · Jun 1999
Bacterial infections in infants 60 days and younger: epidemiology, resistance, and implications for treatment.
To establish what might be more optimal initial antibiotic therapy for suspected invasive bacterial infections in infants 60 days or younger who are evaluated in the emergency department (ED). ⋯ Our results reveal 2 important facts: (1) during a 4-year period, no isolates of Listeria were identified from any patients 60 days or younger; and (2) of the 96 GNRs isolated from patients in the ED, more than 60% were ampicillin resistant. These data suggest that in similar centers with a low incidence of infection with Listeria and high levels of ampicillin resistance among GNRs, empiric use of ampicillin as part of a combination for presumed bacterial infections in patients 60 days or younger initially evaluated in the ED may be neither necessary nor beneficial. Consideration should be given to empiric initial antibiotic therapy using a third-generation cephalosporin with or without gentamicin.