Predicting Outpatient Failure for Cellulitis

Predicting Outpatient Failure for Cellulitis

Tachypnea, chronic ulcers, prior MRSA colonization, and prior cellulitis in the past 12 months were all associated with an increased risk of oral antibiotic failure for treatment of non-purulent cellulitis.

Influenza Kills - A Sobering Reminder

Influenza Kills - A Sobering Reminder

Influenza killed 675 children from the 2010-11 flu season to the 2015-16 season.  Infants under 6 months had the highest incidence of mortality.  Encourage everyone to get vaccinated.  Antiviral treatment is encouraged in all children under 2, all patients with severe illness, and all hospitalized patients regardless of whether or not the duration of illness exceeds 48 hours.

Fluoroquinolones - Risk of Aortic Aneurysm and Dissection

Fluoroquinolones - Risk of Aortic Aneurysm and Dissection

Fluoroquinolone use was associated with increased risk of developing newly diagnosed aortic aneurysm or dissection.

MRSA - I&D Only or Add Antibiotics?

MRSA - I&D Only or Add Antibiotics?

This meta-analysis of 4 RCTs found anti-MRSA antibiotics in addition to I&D led to a far better cure rate than I&D alone.

Metro Is So Retro - C. diff Guidelines

Metro Is So Retro - C. diff Guidelines

If you're still reaching for metronidazole in patients with suspected or confirmed C. difficile colitis, it's time to get up to speed with this summary.

PECARN - Only 1 in 500 Infants Have Bacterial Meningitis at 29-60 Days

PECARN - Only 1 in 500 Infants Have Bacterial Meningitis at 29-60 Days

Bacteremia and bacterial meningitis occurred in 3.1% and 1.3% of infants </=28 days, respectively; 1.1% and 0.2% of infants 29-60 days, respectively.  With a 1/500 chance of bacterial meningitis in infants 29-60 days, reasonable physicians may disagree on the merits of the lumbar puncture in this group.

Rhinovirus on RVP - What Does It Mean?

Rhinovirus on RVP - What Does It Mean?

Don't be falsely reassured if rhinovirus on a PCR viral panel is positive.  The incidence of UTI was unchanged if </= 90 days, and the incidence of invasive bacterial infection (IBI) was no different </= 28 days.  However, it may prove useful for risk stratifying infants for IBI in the 29 to 90-day age group.

Cephalexin for Pediatric UTI

Cephalexin for Pediatric UTI

A push to use cephalexin vs cefixime for uncomplicated pediatric UTI was successful at this medical center.  Whether this is an improvement in prescribing depends upon local E. coli resistance.

Broad Spectrum Antibiotics in Kids - No More Effective, More Complications

Broad Spectrum Antibiotics in Kids - No More Effective, More Complications

Broad spectrum vs narrower spectrum antibiotics for routine pediatric respiratory infections were not more effective and were associated with an increased rate of complications.

Hold the Z-Pak for Pediatric Pneumonia

Hold the Z-Pak for Pediatric Pneumonia

Young children with community acquired pneumonia seemed to do fine with a beta-lactam antibiotic only and didn't appear to benefit from adding a macrolide.

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