Is It Just The Vaccine? Post-Vaccination Fever in Infants
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Serious bacterial infections were exceedingly rare in this study of recently immunized infants 6-12 weeks presenting to the emergency department with a fever.
Source
Serious bacterial infection risk in recently immunized febrile infants in the emergency department. Am J Emerg Med. 2024 Mar 24;80:138-142. doi: 10.1016/j.ajem.2024.03.025. Epub ahead of print. PMID: 38583343.
STOP RCT – Duration of Antibiotics for Pediatric Febrile UTI
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The Short-Course Oral Antibiotic Therapy of Acute Pyelonephritis (STOP trial) demonstrated that a 5-day course of amoxicillin-clavulanate was noninferior to the standard 10-day course with regard to recurrence of infection.
Source
STOP Trial Group. Short Oral Antibiotic Therapy for Pediatric Febrile Urinary Tract Infections: A Randomized Trial. Pediatrics. 2024 Jan 1;153(1):e2023062598. doi: 10.1542/peds.2023-062598.
How to Choose Wisely in PEM
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The 5 Choosing Wisely recommendations for pediatric emergency medicine (PEM) focus on decreasing diagnostic testing related to respiratory conditions, medical clearance for psychiatric conditions, seizures, constipation, and viral respiratory tract infections.
Treatment Options for Cough and URI in Children
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Clinicians have an important role in advising families on the appropriate evidence-based treatments for upper respiratory tract infections (URTIs) in children.
Source
Treatments for cough and common cold in children. BMJ. 2024 Jan 25;384:e075306. doi: 10.1136/bmj-2023-075306.
Pay to Play – Telehealth and Inappropriate Antibiotics
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Using online telemedicine platforms, the authors found that it was appallingly easy to rapidly obtain inappropriate antibiotic prescriptions for symptoms of viral URIs by paying a nominal fee. This highlights the need for increased education and regulations around inappropriate prescribing of antibiotics to safeguard the public and uphold good medical practices.
Source
Antibiotics on Demand: Advances in Asynchronous Telemedicine Call for Increased Antibiotic Surveillance. Clin Infect Dis. 2024 Feb 17;78(2):308-311. doi: 10.1093/cid/ciad472.
Oseltamivir Won’t Keep You Out of the Hospital
Exciting news! JournalFeed and Dr. Amal Mattu's Top Picks Video Series is set to GO LIVE this week! It's free for Gold Spoon members or you can just get the video series. Watch this trailer and get excited!
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This systematic review and meta-analysis concluded, with moderate certainty evidence, that oseltamivir has little to no effect on hospitalization but does increase nausea and vomiting.
Source
Evaluation of Oseltamivir Used to Prevent Hospitalization in Outpatients With Influenza. JAMA Intern Med. 2024 Jan 1;184(1):18-27. doi: 10.1001/jamainternmed.2023.0699. Erratum in: JAMA Intern Med. 2023 Nov 20;: PMID: 37306992; PMCID: PMC10262060.
New Guidelines for Mild Pediatric TBI
Exciting news! JournalFeed and Dr. Amal Mattu's Top Picks Video Series is set to GO LIVE next week! It's free for Gold Spoon members or you can just get the video series. Watch this trailer and get excited!
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In this systematic review, authors identified clinical practice guideline (CPG) recommendations with moderate to high quality evidence that can be used by the ED practitioner to help in the care of pediatric patients with mild traumatic brain injury (mTBI).
Source
Clinical Practice Guideline Recommendations in Pediatric Mild Traumatic Brain Injury: A Systematic Review. Ann Emerg Med. 2023 Dec 22:S0196-0644(23)01381-1. doi: 10.1016/j.annemergmed.2023.11.012. Epub ahead of print.
Direct Oral Challenge – Bye-Bye Penicillin Allergy!
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While removing low risk amoxicillin allergies in the pediatric ED setting by direct oral challenge (DOC) may be effective, numerous factors play a role in reliable implementation.
Source
Multisite Oral Amoxicillin Challenges During Pediatric Emergency Department Visits. JAMA Pediatr. 2023 Oct 2:e233659. doi: 10.1001/jamapediatrics.2023.3659. Online ahead of print.
Hemolytic Uremic Syndrome from Shiga-Toxin Producing E. coli
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This article provides a review of hemolytic-uremic syndrome (HUS) associated with Shiga toxin-producing Escherichia coli (STEC) infection. This condition, which disproportionately impacts children under five, is defined by thrombocytopenia, non-immune hemolytic anemia, and azotemia caused by thrombotic microangiopathy.
Bulb vs Suction Gadget – Does Type of Nasal Suctioning Help Infants with Bronchiolitis?
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In a randomized control trial of discharged infants with bronchiolitis, enhanced home nasal suctioning with a mechanical device did not lead to reduced unscheduled health care revisits as compared to standard bulb suctioning.
Nasal Suctioning Therapy Among Infants With Bronchiolitis Discharged Home From the Emergency Department: A Randomized Clinical Trial. JAMA Netw Open. 2023;6(10):e2337810. Published 2023 Oct 2.