Abstract：
:Antimicrobial resistance is a key factor leading to emerging/ re-emerging infections. Rational antimicrobial therapy or antimicrobial stewardship is one of the important interventions to prevent emergence of resistance. Choosing correct empiric therapy is crucial not only to prevent antimicrobial resistance but also to achieve good treatment outcomes. Antimicrobial therapy can be broadly classified as empiric, definitive/ targeted and preventive. It is in choice of empiric therapy that the largest margin of error exists. Paradoxically, empiric therapy is the most commonly employed therapy since microbiologic results are either not available at initiation of treatment or cannot be sent due to logistic reasons or are negative. In the Indian setting, where penetration of microbiologic diagnostic methods in small cities, towns and rural areas is still fairly low, therapy is largely empiric. Choice of empiric therapy is governed by various factors including likely pathogens, antimicrobial resistance, degree of sickness, site of infection and host co-morbidities. These principles can be applied to any clinical syndrome whether it is fever without focus, infections of the respiratory tract, gastrointestinal tract, abdomen, central nervous system, bone and joint, skin and soft tissue, urinary tract as well as neonatal sepsis and healthcare associated infections. Adherence to published guidelines for syndromic management such as that by the Indian Academy of Pediatrics and Indian Council of Medical Research is strongly recommended. One can tailor these guidelines and suggestions made in this article to an individual setting.
journal_name
Indian J Pediatrjournal_title
Indian journal of pediatricsauthors
Singhal Tdoi
10.1007/s12098-019-03144-7subject
Has Abstractpub_date
2020-11-01 00:00:00pages
945-950issue
11eissn
0019-5456issn
0973-7693pii
10.1007/s12098-019-03144-7journal_volume
87pub_type
杂志文章,评审abstract：:Hirschsprung disease is a common cause of neonatal and infantile large gut obstruction. It is characterised by varying extent of contiguous aganglionosis extending from the anorectum proximally. Since its recognition, the diagnosis and management has continuously evolved with advances in histological evaluation and su...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章,评审
doi：10.1007/s12098-017-2371-8
更新日期：2017-08-01 00:00:00
abstract：:The clinical presentation of pseudohypoaldosteronism (PHA) mimics congenital adrenal hyperplasia (CAH). Poor response of the dehydration and electrolyte abnormalities to steroid therapy should make one suspect PHA. The treatment is supportive in the form of salt replacement and sodium resonium. We report a case of PHA...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章
doi：10.1007/BF02758269
更新日期：2006-01-01 00:00:00
abstract：:Epilepsy surgery is safe and effective treatment in children who fail to respond to antiepileptic medications. After failure of two appropriate antiepileptic medications, chances that the child will become seizure free with more or different medications is <5%, and she should be diagnosed with "refractory epilepsy". A...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章,评审
doi：10.1007/s12098-014-1541-1
更新日期：2014-10-01 00:00:00
abstract：:Tuberous sclerosis complex (TSC) is an autosomal dominant disorder, caused due to mutations in the TSC1 and TSC2 genes. Mutations in TSC2 gene are more common than in TSC1 gene and mostly they are in the form of large genomic deletions or duplications. The authors report on a novel deletion in TSC2 gene, prenatal diag...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章
doi：10.1007/s12098-011-0408-y
更新日期：2012-10-01 00:00:00
abstract：:In this review, the clinical features and management of most commonly encountered acyanotic, left-to-right shunt lesions are discussed. Patients with small defects, especially in childhood, are usually asymptomatic while moderate to large defects in infancy may present with symptoms. Hyperdynamic precordium, widely sp...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章,评审
doi：10.1007/BF02724429
更新日期：2005-06-01 00:00:00
abstract：: ...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章
doi：10.1007/s12098-018-2720-2
更新日期：2019-01-01 00:00:00
abstract：:Gastro-esophageal reflux (GER) is a common occurrence in newborns and a cause of anxiety to most parents. This physiological process needs to be closely differentiated from pathological reflux. The clinical signs in infants are generally non-specific which makes the distinction difficult. The diagnostic options in inf...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章,评审
doi：10.1007/s12098-014-1535-z
更新日期：2015-01-01 00:00:00
abstract：:Fibrochondrogenesis is a rare lethal short-limb skeletal dysplasia. Till now only fifteen cases have been reported since Lazzaroni-Fossati first described it in 1978. Hence reported a case of fibrochondrogenesis in a child born to a consanguineously married couple with characteristic physical and radiological features...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章
doi：10.1007/BF02724021
更新日期：2005-04-01 00:00:00
abstract：: ...
journal_title：Indian journal of pediatrics
pub_type： 信件
doi：10.1007/s12098-018-2771-4
更新日期：2019-02-01 00:00:00
abstract：:With the rising prevalence of childhood obesity, pediatricians are increasingly called upon to treat clinically overweight children. The primary treatment options are behavioral lifestyle modification, pharmacotherapy, and surgery. The cornerstone of childhood obesity treatment is lifestyle modification and has been s...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章,评审
doi：10.1007/s12098-012-0766-0
更新日期：2013-03-01 00:00:00
abstract：:The clinical disappearance of the murmur of rheumatic mitral regurgitation after period of time has been documented by many researchers. However no studies have related the disappearance of the murmur with the functional or anatomical state of the mitral valve. This study was done to elucidate the mitral valve status ...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章
doi：10.1007/BF02825126
更新日期：1995-11-01 00:00:00
abstract：:Two hundred and forty two mothers in 7 villages of Narayanganj district, Bangladesh were interviewed to assess their knowledge and attitude regarding breastfeeding and weaning using pretested questionnaires, though 83.5% mothers knew that colostrum is good for the child, less than 8 percent of them gave it as the firs...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章
doi：10.1007/BF02752329
更新日期：1995-03-01 00:00:00
abstract：:Microscopic polyangiitis (MPA) is a small vessel multisystemic disorder characterised by necrotising small vessel vasculitis without any immune deposits. Kidney and lung are the predominant organs affected in MPA. Skin, gastrointestinal and neurological findings are also described. Isolated pulmonary manifestations ar...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章
doi：10.1007/s12098-017-2379-0
更新日期：2017-10-01 00:00:00
abstract：:Helicobacter pylori is one of the commonest bacterial pathogens in human. The organism is associated with development of peptic ulcer diseases, lymphoproliferative disorders and gastric cancer. Residence in a developing country, poor socio-economic conditions and genetic predisposition are regarded as risk factors. Pr...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章,评审
doi：10.1007/s12098-007-0046-6
更新日期：2007-03-01 00:00:00
abstract：:Interpersonal communication between pediatricians and mothers is both complex and interdependent. The mother is dependent on the pediatrician for her child's wellbeing and care along expertise-related dimensions for which she cannot provide. The pediatrician is dependent on the mother's ability to provide accurate inf...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章,评审
doi：10.1007/s12098-012-0934-2
更新日期：2013-12-01 00:00:00
abstract：:Heterotopic neuroglial condition is a rare congenital anomaly in children. Most of the reported cases have been located in nose. To date, there was no recorded case of heterotopic neuroglial tissue in hard palate without any other congenital anomaly. The purpose of this report is to present a rare case of heterotopic ...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章
doi：10.1007/BF02725640
更新日期：2004-05-01 00:00:00
abstract：:Spontaneous perforation of extrahepatic bile duct is rare. The cause is idiopathic once trauma and choledochal cyst are ruled out. The condition presents a diagnostic dilemma. Preoperative recognition is necessary as early surgical intervention gives excellent prognosis. We report clinical observations made in three c...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章
doi：10.1007/s12098-007-0091-1
更新日期：2007-05-01 00:00:00
abstract：:The authors report a case of intra-abdominal migration of a Kirschner wire from the left hip to the right lobe of the liver in a 5-year-old child. The wire was used for stabilization of the left hip after open reduction for neglected unreduced congenital dislocation of the left hip. The migrated wire was removed by la...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章
doi：10.1007/BF02763056
更新日期：2006-12-01 00:00:00
abstract：:Castleman's disease is an atypical lymphoproliferative disorder having two types of presentation--the localized and the multicentric form. The localized form presents as a slowly growing mass with a relatively benign course. Multicentric Castleman's disease has a more aggressive clinical course with diffuse lymph node...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章,评审
doi：10.1007/s12098-007-0210-z
更新日期：2007-12-01 00:00:00
abstract：:Among the neural tube defects incidence of spinabifida and myelomeningocele is less in twins compared to singletons. This article reports a case of dizygotic twins with myelomeningocele, a rare occurrence. Possible association of twining and neural tube defects and its impact on genetic counseling in such cases has be...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章
doi：10.1007/BF02725595
更新日期：2003-03-01 00:00:00
abstract：:In the pediatric patient, computed tomography (CT) scan as an imaging modality for evaluation of the abdomen is to be used judiciously. The use of correct scanning protocols, single phase scanning, scanning only when required are key factors to minimize radiation doses to the child, while providing diagnostic quality....
journal_title：Indian journal of pediatrics
pub_type： 杂志文章,评审
doi：10.1007/s12098-016-2030-5
更新日期：2016-07-01 00:00:00
abstract：:Approximately 25,000 children develop multidrug-resistant (MDR) tuberculosis (TB) each year, but few of them are diagnosed and appropriately treated for MDR-TB. New diagnostic tools have improved our ability to diagnose children with bacteriologically confirmed TB earlier. However, the majority of childhood TB cases a...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章,评审
doi：10.1007/s12098-018-02846-8
更新日期：2019-08-01 00:00:00
abstract：OBJECTIVE:To evaluate the impact of co-occurring attention-deficit/hyperactivity disorder (ADHD) on the health-related quality of life (HRQOL) of children with newly diagnosed specific learning disability (SpLD). METHODS:From September 2005 to March 2006, 150 parents (either mother or father) of children consecutively...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章
doi：10.1007/s12098-009-0240-9
更新日期：2009-11-01 00:00:00
abstract：:High dose vitamin A (HDVA) concentrate began to be distributed in India in 1970 as a short-term, stop-gap approach to reduce clinical signs of vitamin A deficiency. As this problem declined globally, the purpose of distributing them changed to the reduction of young child mortality. However, their impact on this has a...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章,评审
doi：10.1007/s12098-018-02851-x
更新日期：2019-06-01 00:00:00
abstract：OBJECTIVE:To investigate the effect of early erythropoietin treatment on induction of erythropoiesis and the need for transfusion in Very Low Birth Weight (VLBW) infants with acute neonatal problems. METHODS:The study group consisted of 14 VLBW prematures with gestational ages less than 32 weeks who were given subcuta...
journal_title：Indian journal of pediatrics
pub_type： 临床试验,杂志文章
doi：10.1007/BF02722624
更新日期：2002-05-01 00:00:00
abstract：OBJECTIVE:Cholestatic jaundice in early infancy is a complex diagnostic challenge. Cholestasis caused by endocrine disease is rare and poorly recognized. The aim of this paper is to report patients with liver dysfunctions resulting from hypopituitarism. METHODS:Six patients with liver dysfunction diagnosed as hypopitu...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章
doi：10.1007/s12098-018-2833-7
更新日期：2019-05-01 00:00:00
abstract：:The packing and composition of ORS has undergone a change since its introduction. In India, some companies are manufacturing smaller pouches (4.2 g) to be dissolved in 200 ml of water. Therefore, out of confusion some prescribers routinely advise the patients to dissolve the standard formulation ORS pouch (21 g) in a ...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章
doi：10.1007/s12098-010-0095-0
更新日期：2010-06-01 00:00:00
abstract：:The advent of AIDS has raised a concern regarding transfusion transmitted diseases. Blood transfusion is safer than ever before through continued improvements in safe donor recruitment, screening of donors, testing of donated blood and appropriate clinical use of blood. The risk of residual infections is further reduc...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章,评审
doi：10.1007/BF02722029
更新日期：2001-02-01 00:00:00
abstract：:An 11-mo-old infant received 12.5 times the maximum therapeutic dose of amlodipine as a result of a medication error in lieu of amoxicillin. He presented with vomiting, lethargy, breathlessness, muffled heart sounds and progressed to hypotensive shock within three hours of admission. He received mechanical ventilation...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章
doi：10.1007/s12098-012-0861-2
更新日期：2013-06-01 00:00:00
abstract：:Distinction between true and pseudo trail in lumbo-sacral region is important since treatment and prognosis are different. Fewer than 40 cases have been reported in literature. The authors report a case of true tail in a neonate, a rare event. ...
journal_title：Indian journal of pediatrics
pub_type： 杂志文章
doi：
更新日期：2005-02-01 00:00:00
