Physicians who wrote for the most antibiotics were also the ones who diagnosed sinusitis most often. To justify writing for an antibiotic, there was a coding bias to call it “sinusitis” when in fact, it probably was just a cold.
Overall yield of blood culture for pediatric community acquired pneumonia (CAP) was low; 91 blood cultures were needed to get one positive result. But in children admitted to the ICU, one child had bacteremia for every 24 cultures obtained; one for every 12 in children with parapneumonic effusion.
Infants ≤60 days of life with hypothermia (< 36 °C) had serious bacterial infection (SBI) 2.8% of the time. There is a suggestion that those 15-28 days with high absolute neutrophil count (ANC) and thrombocytopenia had even greater odds of SBI.
Hyperlactatemia appears to arise from impaired oxygen utilization more often than decreased O2 delivery but doesn’t cause acidemia unless there is impaired renal function. The novel “alactic base excess” may give us an early way to tell when the kidneys are failing to compensate.
In this survey of physicians from Canada and UK/Ireland, the strongest predictors of performing a LP in neonates with a clinical diagnosis of bronchiolitis were: practice location in Canada, <10 years in practice, and less comfort diagnosing bronchiolitis.