Abstract:
OBJECTIVE:To determine if intramuscular (IM) penicillin is more effective than oral (PO) amoxicillin in the early outpatient treatment of pediatric patients with presumed bacterial pneumonia. METHODS:Prospective, randomized, evaluator-blinded, clinical trial. SETTING:Pediatric emergency department (ED) of an urban children's hospital. PATIENTS:ED patients with radiographically confirmed pneumonias managed as outpatients. Patients with chronic illnesses, wheezing, allergy to amoxicillin or penicillin, recent antibiotic therapy, or concurrent diagnosis of another febrile illness were excluded. INTERVENTIONS:Patients received either a two-day supply of PO amoxicillin (50 mg/kg/day divided tid), or an IM injection of procaine penicillin G (PPG) (50,000 units/kg). They had a complete blood count (CBC), blood culture, and nasopharyngeal swab for viral culture done at initial visit. They returned in 24 to 36 hours for reevaluation. OUTCOME MEASURES:The main measures were temperature, respiratory rate, and general appearance score; additional measures were accessory muscle use, pulse oximetry, parental report of activity/oral intake. RESULTS:One hundred seventy patients were enrolled. There were no significant differences between the two groups at initial or follow-up visits with respect to temperature, respiratory rate, accessory muscle use, pulse oximetry, or parental reports of activity level and oral intake. Only in the general appearance of children less than two years of age did there appear to be a difference (P = 0.03). When subanalysis excluded patients with positive viral studies (n = 17) or chest x-rays "reread" by an attending pediatric radiologist as "no infiltrate" (n = 29), this difference disappeared (P = 0.10). Three patients in the PO group, and five in the IM group failed by all three main outcome measures (P = 1.00). Four patients in the PO group, and five in the IM group were hospitalized at the follow-up visit (P = 1.00). CONCLUSION:There does not appear to be a significant difference between PO amoxicillin and IM penicillin in the early outpatient treatment of pediatric patients with presumed bacterial pneumonia.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Tsarouhas N,Shaw KN,Hodinka RL,Bell LMsubject
Has Abstractpub_date
1998-10-01 00:00:00pages
338-41issue
5eissn
0749-5161issn
1535-1815journal_volume
14pub_type
临床试验,杂志文章,随机对照试验abstract:INTRODUCTION:Although retropharyngeal infection (RPI) may present with voice change, drooling, fever, and a toxic appearance, diagnosis based on symptoms alone is unreliable. As incidence is increasing in children and drug-resistant bacterial strains such as methicillin-resistant Staphylococcus aureus are becoming more...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001318
更新日期:2020-05-01 00:00:00
abstract::The aim of this report is to describe the successful use of pralidoxime in a pediatric patient who accidentally ingested 12 mg of rivastigmine and presented to the emergency department with weakness, drowsiness, hyporeactivity to environmental stimuli, and full cholinergic syndrome. CASE:The patient presented to the ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001086
更新日期:2018-10-01 00:00:00
abstract::We describe an unusual case of a toddler diagnosed with an idiopathic seizure disorder that later was proved to be caused by deliberate administration of amitriptyline by his custodian. In spite of seizures associated with widened electrocardiographic wave (QRS) and right axis deviation on the electrocardiogram (EKG),...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199906000-00011
更新日期:1999-06-01 00:00:00
abstract:BACKGROUND:Few studies have addressed the presentation and clinical impact of pediatric pelvic fractures. We sought to describe pediatric blunt trauma patients with pelvic fracture (PF) and to evaluate the sensitivity and specificity of physical examination at presentation for diagnosis. METHODS:Retrospective analysis...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200102000-00004
更新日期:2001-02-01 00:00:00
abstract::This case provides the first report of a young healthy child presenting in septic shock from Clostridium difficile colitis. This child had no identifiable risk factors for C. difficile, raising the suspicion for a hypervirulent strain. Once infection was recognized and treated appropriately, the child made a full reco...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000496
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to understand parents' awareness of and reactions to a slide presentation based waiting-room educational initiative. METHODS:This was a prospective observational study at a Canadian tertiary-care pediatric emergency department (ED) with an annual census of 68,000 visits. An anonymou...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001140
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the accuracy of the initial impression of emergency department providers on the disposition of children with asthma exacerbation. METHODS:We conducted a prospective survey of physicians and other providers in the emergency department of a children's hospital and parents ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001723
更新日期:2019-02-01 00:00:00
abstract::Donepezil and memantine are commonly prescribed antidementia drugs. There is a paucity of literature concerning pediatric ingestions of these drugs. We describe a case of a 2-year-old child who developed encephalopathy after an unintentional ingestion of donepezil and memantine. A 2-year-old girl was found by her fami...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000216
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy of a single dose of oral dexamethasone (Dex) versus 5 days of twice-daily prednisolone (Pred) in the management of mild to moderate asthma exacerbations in children. STUDY DESIGN:A prospective, randomized, double-blinded trial of children 2 to 16 years of age who presented to the emer...
journal_title:Pediatric emergency care
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.pec.0000248683.09895.08
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVES:Lollapalooza (LP) is an annual 3-day outdoor music festival in Chicago. Underage drinking and drug use are believed to be common, but the burden on emergency departments (EDs) has not been documented. We assessed the burden on health care resources associated with this music festival. METHODS:We performed a...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001072
更新日期:2019-06-01 00:00:00
abstract::The etiology of acute liver failure varies widely in children, but the most common causes are viral hepatitis, drugs, and toxins. We report herein a case of autoimmune hepatitis and acute liver failure caused by leptospirosis, which is involved rarely in etiology. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182309e79
更新日期:2011-10-01 00:00:00
abstract::Neck pain is a relatively common pediatric complaint. Most is of benign etiology. We present an unusual case of epidural abscess with associated discitis in the cervical spine of a 12-year-old after a dental extraction. This potentially dangerous complication was diagnosed before neurological complications developed a...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181c8c60b
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVE:We examined financial barriers to care experienced by US school-aged children with disabilities. METHODS:Data from the 2005 National Health Interview Survey were analyzed. Children aged 5 to 17 years were classified into 4 health condition groups: children with activity limitations, disabling conditions, chr...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318180fda3
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:To study the use of trauma series radiographs in children that required activation of a trauma call. METHODS:A retrospective review of patients younger than 16 years who presented to The Children's Hospital at Westmead between January and December 2004 with an injury that required activation of the trauma t...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000236833.62065.85
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to describe a single institutional experience with pediatric diffuse pulmonary hemorrhage, with an emphasis on etiology, clinical course, and outcome. METHODS:The medical records of pediatric patients admitted to Assaf Harofeh Medical Center between the years 2002 and 2011 beca...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318271c107
更新日期:2012-11-01 00:00:00
abstract::Owing to its lower incidence in young children, appendicitis is not as often thought of as a common cause of abdominal pain and vomiting in this age group. However, because of its higher incidence of morbidity (perforation and peritonitis), it should be considered in any young child with either significant abdominal p...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199710000-00012
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVES:Nonoperative management of hemodynamically stable liver lacerations in pediatric trauma patients is a safe and effective management strategy for pediatric patients; approximately 90% will be successfully managed nonoperatively. No study has specifically identified risk criteria for the need for intervention ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001538
更新日期:2020-07-01 00:00:00
abstract::Atypical manifestations of acute hepatitis A virus (HAV) infection include ascites, pleural effusion, acute renal failure, aplastic anemia, and neurological manifestations. Although association of HAV and acute cholecystitis is known, presentation of hepatitis A infection with acute cholecystitis has not been reported...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318258bdda
更新日期:2012-06-01 00:00:00
abstract::It has been estimated that up to 27% of all medical emergencies presenting to emergency departments are due to hypertension, predominantly in the adult population. Although this often is an insidious process, acutely, a hypertensive emergency occurs when a patient presents with severe hypertension and evidence of end ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181a34816
更新日期:2009-05-01 00:00:00
abstract::We present two cases of pediatric patients initially presenting with a clinical suspicion of acute appendicitis. In these cases, point-of-care ultrasonography was performed early in the patient's emergency department course, leading to alternate diagnoses. This article highlights a role for point-of-care ultrasound in...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000623
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVES:The Accreditation Council for Graduate Medical Education requires pediatric residency training programs to provide exposure to the prehospital management and transport of patients. The authors hypothesized that compared with a similar study a decade prior, current pediatric residency training programs have r...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31823ed4ab
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:This study was performed to determine the doses of midazolam used for sedation during procedures in children, and the frequency of adverse events. METHODS:We performed a retrospective analysis of data collected for a prospective study of flumazenil in children who had received midazolam for a procedure (n = ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199906000-00001
更新日期:1999-06-01 00:00:00
abstract::The development of leadership and management skills requires a commitment to personal introspection and the development of self-knowledge. Difficult decisions concerning the determination of that which is truly important is central to the process. At both the personal and organizational levels, this process can be fac...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/00006565-199506000-00014
更新日期:1995-06-01 00:00:00
abstract:OBJECTIVES:Effective leadership and teamwork are imperative during pediatric cardiopulmonary resuscitations (CPR). The initial phase of pediatric CPR, termed the "first 5 minutes," has significant care delivery gaps in both leadership and team performance. The aim of the study was to describe the performance data of em...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001923
更新日期:2019-12-13 00:00:00
abstract::The recent popularity of elastic bands on the wrist may put children at risk for acute compartment syndrome. Acute compartment syndrome is a limb-threatening condition characterized by elevated interstitial pressure in a confined fascial compartment. If left untreated, it may result in tissue necrosis, irreversible ne...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318217b5a7
更新日期:2011-05-01 00:00:00
abstract::A 4-year-old boy, who had no prior history of convulsions, presented with inability to walk, disequilibrium, dysarthria (incoherent speech), and impaired cognition (disorientation) following the instillation of 1% cyclopentolate, a commonly used mydriatic in pediatric practice. This case demonstrates the uncommon, alt...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182417a63
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:This study aimed to investigate the management of pediatric patients with diabetic ketoacidosis (DKA) presenting to emergency departments (EDs) participating in the Illinois Emergency Medical Services for Children (EMSC) Facility Recognition program. METHODS:In 2010, Illinois EMSC conducted a survey (includi...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182768bfc
更新日期:2012-12-01 00:00:00
abstract::Diagnosis and treatment of laryngeal clefts (LCs) particularly type I pose a challenge. Although rare, type I LCs are becoming increasingly identified in recent years, and this is perhaps due to both an increased awareness and better diagnostic modalities. We report a young infant presenting with feeding difficulty an...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000001350
更新日期:2019-03-01 00:00:00
abstract::Colchicine is an anti-inflammatory drug, which has been used for the treatment of familial Mediterranean fever for several decades with narrow therapeutic-toxicity window. Colchicine poisoning is rare but frequently a life-threatening emergency condition in pediatric practice. It may occur by excessive ingestion of co...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000545
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:This study aimed to describe the epidemiology of headache in children attending a community mixed adult-pediatric emergency department (ED) in Australia with a view to providing scoping data for future headache-related projects for the pediatric ED research networks. METHODS:This is a retrospective cohort st...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002000
更新日期:2020-01-21 00:00:00