Abstract:
BACKGROUND:Although antibiotics are recommended for the primary care management of community-acquired pneumonia, a recent UK study reported that most children admitted to hospital had not received antibiotics. OBJECTIVE:To describe primary care antibiotic use for children subsequently hospitalised with community-acquired pneumonia. DESIGN/METHODS:A case series of 280 children <5 years old hospitalised with pneumonia in Auckland, New Zealand. Pneumonia was defined as an acute illness with cough or respiratory distress, the presence of tachypnoea or indrawing and an abnormal chest radiograph. Receipt of antibiotics was determined by parental report and medical record review. RESULTS:Fewer than half (108, 39%) of the children had received an antibiotic before hospital admission. For 60 children (21%) there had been no opportunity to prescribe because the illness evolved rapidly, resulting in early hospital admission. For the remaining 112 children (40%) an opportunity to receive antibiotics was missed. The parent failed to obtain the antibiotic prescribed for 23 children (21% of 112), but in 24 children (21%) pneumonia was diagnosed but no antibiotic prescribed and in a further 28 children (25%) the diagnosis was not made despite parental report of symptoms suggesting pneumonia. Missed opportunities to prescribe were not associated with increased overall severity of symptoms at hospital presentation but were associated with an increased risk of: focal chest radiological abnormalities (rate ratio (RR)=2.14; 95% CI 1.49 to 2.83), peripheral leucocytosis >15×10(9)/l (RR=2.29; 95% CI 1.61 to 2.98) and bacteraemia (RR=6.68, 95% CI 1.08 to 58.44). CONCLUSIONS:Young children with community-acquired pneumonia may not receive an antibiotic before hospital admission because the illness evolves rapidly or the prescribed medicine is not given by parents. However, missed opportunities for appropriate antibiotic prescribing by health professionals in primary care appear to be common.
journal_name
Arch Dis Childjournal_title
Archives of disease in childhoodauthors
Grant CC,Harnden A,Mant D,Emery D,Coster Gdoi
10.1136/archdischild-2011-300604subject
Has Abstractpub_date
2012-01-01 00:00:00pages
21-7issue
1eissn
0003-9888issn
1468-2044pii
archdischild-2011-300604journal_volume
97pub_type
杂志文章abstract:BACKGROUND AND AIMS:There are few standardised questionnaires for the assessment of respiratory symptoms in preschool children. We have developed and tested the short-term repeatability of a postal questionnaire on respiratory symptoms for 1-year-old children. METHODS:A newly developed postal questionnaire for the ass...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2007.117978
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:Recent research in febrile neutropaenia (FN) has focused on reducing the intensity of treatment for those thought to be at low risk of significant morbidity or mortality. This has not led to a reduced burden of treatment for either families or healthcare systems. An alternative approach is to discharge all p...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2019-317908
更新日期:2020-09-01 00:00:00
abstract::Nerve growth factor (NGF) is the first described neurotrophin that stimulates the growth and differentiation of nerve cells and promotes skin and peripheral tissue regeneration. Recent studies suggest that NGF influences endothelial cell proliferation and angiogenic activity. In view of these proposed regenerative eff...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.87.5.446
更新日期:2002-11-01 00:00:00
abstract::To determine the natural history and psychological impact of the growth pattern in boys with constitutional delay in growth and puberty (CDGP), 43 boys presenting with short stature due to CDGP were followed up to final height. At presentation mean (SD) chronological age was 14.0 (1.9) years, bone age delay 2.7 (1.0) ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.65.10.1109
更新日期:1990-10-01 00:00:00
abstract:OBJECTIVE:The development, delivery and evaluation of a training programme for medical and nursing professionals on best practice for informing families of their child's disability. DESIGN:A 2 h training course on 'Best practice guidelines for informing families of their child's disability' was designed based on the f...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2012-303037
更新日期:2013-06-01 00:00:00
abstract::By means of a simple questionnaire and measurements of height, weight, and peak expiratory flow rates 3061 children from city and rural populations were studied. Children with asthma or other respiratory diseases had lower peak expiratory flow rates, and younger children living in rural areas had higher rates. In 2828...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.64.1.96
更新日期:1989-01-01 00:00:00
abstract::The performance of indirect indices of infection in the newborn vary because of differences in techniques, including diagnostic cut off levels. We have compared serial neutrophil band cell counts with C reactive protein measured by rate nephelometry. The 'gold standard' was a positive culture and the performance of th...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.67.7_spec_no.808
更新日期:1992-07-01 00:00:00
abstract::162 children with infantile spasms were treated with ACTH at the Children's Hospital, Helsinki, and at the Aurora Hospital, Helsinki, during 1960--76. In a large proportion (37%) of the children the treatment caused pronounced side effects, and the mortality was 4.9%. The most common complications were infections: sep...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.55.9.664
更新日期:1980-09-01 00:00:00
abstract::Somatomedin activity was assayed in the plasma of children suffering from protein calorie malnutrition by a bioassay using rat cartilage and expressed as sulphate uptake ratio. The sulphate uptake ratio was particularly reduced in kwashiorkor. In marasmus there was a slight reduction and the levels were still in the n...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.54.1.62
更新日期:1979-01-01 00:00:00
abstract::In a prospective follow up of 116 high risk infants, a 24 hour behavioural chart on seven consecutive days was analysed at seven and 12 weeks of age. Of children who manifested atopic disease at 2 years, 44/116 (38%), had shown significantly more fussing during the seventh, and colic type cry during the twelfth week t...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.84.4.349
更新日期:2001-04-01 00:00:00
abstract::A picture archiving and communication system (PACS) is a computerised means of replacing the roles of conventional radiological film. This review describes the Hammersmith PACS, and discusses the advantages and disadvantages of PACS systems. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/adc.83.1.82
更新日期:2000-07-01 00:00:00
abstract::Concerns have been expressed in recent years about the decline in children's clinical and biomedical research in the UK, and in the paediatric academic workforce. Here I consider the extent to which these concerns are justified, the sweeping changes that have taken place in research funding, governance and organisatio...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2009.178160
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:To undertake a systematic review and meta-analysis to establish the effectiveness of handwashing in reducing absence and/or the spread of respiratory tract (RT) and/or gastrointestinal (GI) infection among school-aged children and/or staff in educational settings. DESIGN:Randomised-controlled trials (RCTs). ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,meta分析,评审
doi:10.1136/archdischild-2015-308875
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND AND AIMS:Data on acute paediatric anaphylaxis presentations to the emergency department (ED) are limited. All allergic presentations to one Australian paediatric ED were studied to determine epidemiological, clinical, and outcome data. METHODS:Retrospective, case based study of patients under 16 years atten...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2004.069914
更新日期:2006-02-01 00:00:00
abstract::Increased emphasis on strict glycaemic control of insulin dependent diabetes mellitus (IDDM) in young patients may be expected to cause increases in rates of significant hypoglycaemia. To evaluate whether this is the case for a large population based sample of IDDM children and adolescents rates of severe (coma, convu...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.78.2.111
更新日期:1998-02-01 00:00:00
abstract::The temperatures of 587 children were taken before and after diphtheria/tetanus/pertussis (DTP) or diphtheria/tetanus (DT) vaccine. Only slight temperature increases were found but these were notably more frequent after plain than adsorbed DTP vaccine preparations and the frequency increased with each successive dose....
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.58.11.921
更新日期:1983-11-01 00:00:00
abstract::Six healthy children, born in the UK, travelled to their parental homeland and developed a severe form of traveller's diarrhoea. This was characterised by rapid loss of weight and chronic diarrhoea. On return to this country, investigation in 5 of them showed an abnormal, small intestinal mucosa. There was a high inci...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.57.3.208
更新日期:1982-03-01 00:00:00
abstract::The clinical patterns of adverse reactions to cows' milk were examined in 72 children with cows' milk hypersensitivity. Two main groups were found, according to the time of onset of the adverse reaction--immediate onset, within one hour of milk ingestion and delayed onset, after one hour. Children with immediate onset...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.58.11.856
更新日期:1983-11-01 00:00:00
abstract::The role of disseminated intravascular clotting (DIC) in the pathogenesis of the bleeding diathesis kwashiorkor was investigated in 22 patients. According to the severity of the clinical and haematological findings, two grades of DIC were observed. A severe grade of DIC was shown in 6 cases (5 fatal) presenting with ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.50.4.308
更新日期:1975-04-01 00:00:00
abstract::A gross T cell lymphocytosis developed in an otherwise healthy 5 year old girl and has persisted for nearly 3 years. It is associated with neutropenia and seems to be typical of a rare adult disorder that may be a type of T cell chronic lymphocytic leukaemia. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.58.8.635
更新日期:1983-08-01 00:00:00
abstract:OBJECTIVE:Use next-generation sequencing (NGS) technology to improve our diagnostic yield in patients with suspected genetic disorders in the Asian setting. DESIGN:A diagnostic study conducted between 2014 and 2019 (and ongoing) under the Singapore Undiagnosed Disease Program. Date of last analysis was 1 July 2019. S...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2020-319180
更新日期:2021-01-01 00:00:00
abstract::Thirty-two children with a past diagnosis of coeliac disease were reinvestigated by means of gluten challenge. They had received a gluten-free diet for a mean period of 6-5 years (range 0-25-11-0) before gluten challenge, and had a mean age of 9-9 years (range 3-0-15-3) at the onset of challenge. Small intestinal biop...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.53.6.449
更新日期:1978-06-01 00:00:00
abstract:BACKGROUND:Medium chain acyl-CoA dehydrogenase (MCAD) deficiency is a common disorder of fatty acid oxidation in north west Europe. It is very variable in its clinical consequences and is believed to be considerably underdiagnosed. OBJECTIVE:To investigate the diagnosis and outcome of MCAD deficiency in the UK. METHO...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.79.2.116
更新日期:1998-08-01 00:00:00
abstract::Serial recording in 45 low risk fetuses throughout the second and third trimesters showed that hiccups were the predominant diaphragmatic movement before 26 weeks' gestational age and that there was a significant negative correlation with gestational age. There was a pronounced reduction between 24 and 26 weeks, which...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.65.10_spec_no.1072
更新日期:1990-10-01 00:00:00
abstract::Bilateral staghorn renal calculi in a 7-year-old girl with cystinuria were dissolved over a period of 6 months, using a high fluid intake, urinary alkalinisation, and D-penicillamine. Even in children with extensive cystine urolithiasis, medical management may avert the need for surgery. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.54.10.795
更新日期:1979-10-01 00:00:00
abstract::Th incidence and severity of posterior subcapsular cataracts were studied in 58 children with steroid-sensitive nephrotic syndrome. Eight (14%) children had cataracts. Visual acuity was normal in all but one child. There was no relationship between total dose or mean daily dose of prednisolone (corrected for body surf...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:
更新日期:1982-01-01 00:00:00
abstract::The clinical response to sodium cromoglycate treatment was compared with its concentration in serum. Twenty five children with asthma entered a 10 week trial of two baseline weeks followed by eight weeks of treatment by the inhalation of 20 mg of sodium cromoglycate spincaps four times a day. Individual clinical respo...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.63.6.592
更新日期:1988-06-01 00:00:00
abstract:BACKGROUND:Clinical examination, while useful, has been shown to be insufficient as the sole screening method in infants. Ultrasound examination at 8 weeks in high risk infants is an integral part of the screening process in some units. AIMS:To show the efficiency of hip sonography in detection of developmental dyspla...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2003.033597
更新日期:2005-06-01 00:00:00
abstract::The zinc content of peripheral blood leucocytes from the cord blood of 63 normal and 20 preterm babies, and of 27 babies with evidence of idiopathic intrauterine growth retardation (IUGR) was measured. Leucocyte zinc depletion was present in babies with acute IUGR (IUGR babies compared with controls, mean 47.8 v 51.5 ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.58.10.807
更新日期:1983-10-01 00:00:00
abstract::The IgG subclass specific immune response against pneumococcal type 3 polysaccharide antigen before and after immunisation in healthy children and children with recurrent bronchitis was studied. Recurrent bronchitis was defined as three or more episodes a year, during at least two consecutive years, of bronchopulmonar...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.66.12.1378
更新日期:1991-12-01 00:00:00