New UTI Culture Cutoff in Children
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A new cutoff of 10,000 colony-forming units per milliliter (CFU/mL) on urine culture to diagnose urinary tract infection (UTI) from catheterized specimens in infants and children <3 years improved sensitivity and specificity.
Source
Support for the Use of a New Cutoff to Define a Positive Urine Culture in Young Children. Pediatrics. 2023 Oct 1;152(4):e2023061931. doi: 10.1542/peds.2023-061931.
Pediatric Sinusitis – Plain Amoxicillin or Amoxicillin-Clavulanate?
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For pediatric patients with acute sinusitis, amoxicillin-clavulanate does not offer treatment benefit over amoxicillin alone and is more likely to be associated with gastrointestinal (GI) side effects and yeast infections than amoxicillin.
Source
Treatment Failure and Adverse Events After Amoxicillin-Clavulanate vs Amoxicillin for Pediatric Acute Sinusitis. JAMA. 2023 Sep 19;330(11):1064-1073. doi: 10.1001/jama.2023.15503.
What Children, If Any, Benefit from Antibiotics for Sinusitis?
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Children with persistent or worsening rhinosinusitis experienced a modest improvement in symptoms when given amoxicillin-clavulanate vs. placebo.
Source
Identifying Children Likely to Benefit From Antibiotics for Acute Sinusitis: A Randomized Clinical Trial. JAMA. 2023;330(4):349-358. doi:10.1001/jama.2023.10854
Should You Use a PPI for Infant Reflux? NO! Here’s Why…
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Proton pump inhibitor (PPI) use in young children is associated with risk of serious infection. It's best to avoid PPI use in the absence of a very clear indication.
Source
Proton Pump Inhibitor Use and Risk of Serious Infections in Young Children. JAMA Pediatr. 2023 Aug 14;e232900. doi: 10.1001/jamapediatrics.2023.2900. Online ahead of print.
Myth Bust – Does Croup Really Get Better in Cold Air?
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Is taking a croupy child outdoors in the cold air an old wive's tale or evidence-based practice? Turns out, it actually works!
Does Concussion Impact a Child’s IQ?
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At least in the initial period, there appears to be no clinically meaningful difference in IQ scores in pediatric patients after a concussion.
Source
IQ After Pediatric Concussion. Pediatrics. 2023. 152(2);e2022060515. https://doi.org/10.1542/peds.2022-060515.
SCOUT RCT | 5 or 10-day Treatment for Pediatric UTI?
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This multi-center, double-blinded, non-inferiority trial found that short-course antimicrobial therapy had relatively low treatment failure rates compared to standard-course in children diagnosed with UTI who showed clinical improvement after 5 days of antibiotics.
Source
Short-Course Therapy for Urinary Tract Infections in Children: The SCOUT Randomized Clinical Trial. JAMA Pediatr. 2023 Jun 26:e231979. doi: 10.1001/jamapediatrics.2023.1979. Epub ahead of print.
How Much Do You Know About Orbital Cellulitis?
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Orbital cellulitis is a high-risk and low-prevalence disease characterized by a painful, red eye, usually with eyelid erythema. Red flags include pain with eye movements, photophobia, diplopia, decreased visual acuity, decreased color vision, and proptosis.
Source
High risk and low prevalence diseases: Orbital cellulitis. Am J Emerg Med. 2023 Jun;68:1-9. doi: 10.1016/j.ajem.2023.02.024. Epub 2023 Feb 26.
Is Doxycycline Safe in Children?
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There is no association of doxycycline and tooth staining in children under 8 when used at usual dose and duration.
Source
Antibiotic Exposure and Dental Health: A Systematic Review. Pediatrics. 2023 Jun 2;e2023061350. doi: 10.1542/peds.2023-061350. Online ahead of print.
Siblings of Children with Suspected Physical Abuse – When to Image
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Asymptomatic contact children of patients presenting with physical abuse are a vulnerable population who should be screened for traumatic injuries. This report details guidelines for radiologic screening.