Abstract：
:Antimicrobial stewardship is a recent concept that embodies the practical, judicious use of antimicrobials to decrease adverse outcomes from antimicrobials while optimizing the treatment of bacterial infections to reduce the emergence of resistant pathogens. The objectives of the present statement are to illustrate the principles of antimicrobial stewardship and to offer practical examples of how to make antimicrobial stewardship part of everyday hospital and outpatient practice. Vital components of antimicrobial stewardship include appropriate testing to diagnose whether infections are viral or bacterial, and using clinical follow-up rather than antibiotics in cases in which the child is not very ill and uncertainty exists. Other specific, important actions include questioning whether positive urine cultures are contaminated when there is no evidence of pyuria or inflammatory changes, and obtaining a chest radiograph to support a diagnosis of bacterial pneumonia. Optimizing the choice and dosage of antimicrobials also reduces the probability of clinical failures and subsequent courses of antimicrobials. A list of common clinical scenarios to promote stew-ardship is included. :La gestion des antimicrobiens est un concept récent qui recouvre l’utilisation pratique et judicieuse des antimicrobiens pour en réduire les effets indésirables tout en optimisant le traitement des infections bactériennes afin de limiter l’émergence d’agents pathogènes. Le présent document de principes vise à exposer les principes de la gestion des antimicrobiens et à donner des exemples pratiques pour les intégrer à la pratique quotidienne en milieu hospitalier et en milieu ambulatoire. Les tests pertinents pour diagnostiquer si les infections sont d’origine virale ou bactérienne et le suivi clinique de préférence aux antibiotiques lorsque l’enfant n’est pas très malade et que l’incertitude persiste sont les éléments essentiels de la gestion des antimicrobiens. Parmi les autres mesures importantes et spécifiques, il faut se demander si les cultures d’urine positives sont contaminées en l’absence de pyurie ou de changements inflammatoires et effectuer une radiographie pulmonaire pour étayer un diagnostic de pneumonie bactérienne. L’optimisation du choix et de la dose d’antimicrobiens réduit également la probabilité d’échecs cliniques et de traitements subséquents. Une liste des scénarios cliniques fréquents afin de promouvoir la gestion des antimicrobiens est également présentée.
journal_name
Paediatr Child Healthjournal_title
Paediatrics & child healthauthors
Le Saux Ndoi
10.1093/pch/19.5.261subject
Has Abstractpub_date
2014-05-01 00:00:00pages
261-70issue
5eissn
1205-7088issn
1918-1485journal_volume
19pub_type
杂志文章abstract：OBJECTIVE:To determine whether reminder notices would improve the timeliness of toddler-age vaccinations. DESIGN:Prospective, randomized, controlled trial. POPULATION STUDIED:Two convenience cohorts of 320 children due to receive either measles-mumps-rubella (MMR) vaccine (at 12 months of age) or diphtheria-pertussis...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：
更新日期：1999-09-01 00:00:00
abstract：:Canadian children and youth travelling overseas face numerous environmental risks, including trauma, extreme temperatures, sun exposure, high altitudes, environmental pollution, and a variety of bites, stings and envenomations. Because skilled emergency response is limited or nonexistent in places where serious illnes...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：10.1093/pch/5.7.387
更新日期：2000-10-01 00:00:00
abstract：:Nutrition is an important part of sport performance for young athletes, in addition to allowing for optimal growth and development. Macronutrients, micronutrients and fluids in the proper amounts are essential to provide energy for growth and activity. To optimize performance, young athletes need to learn what, when a...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：10.1093/pch/18.4.200
更新日期：2013-04-01 00:00:00
abstract：:Within the paediatric population, changing patterns of circumcisions have confounded the epidemiology and presentation of lichen sclerosus (LS). We sought to evaluate the incidence, demographics, and clinical features of patients presenting to a single Albertan paediatric urologist with LS. This retrospective descript...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：10.1093/pch/pxy172
更新日期：2020-06-01 00:00:00
abstract：Background:Constipation is a common condition in children. Little is known about the acute health care utilization of constipated children, including how many present to the paediatric emergency department (ED), the spectrum of presenting complaints, investigations and treatments used. Methods:We conducted a cross-sec...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：10.1093/pch/pxx041
更新日期：2017-06-01 00:00:00
abstract：:Breastfeeding confers extensive and well-established benefits and is recognized as an extremely effective preventative health measure for both mothers and babies. Except in very few specific medical situations, breastfeeding should be universally encouraged for all mothers and infants. To improve worldwide breastfeedi...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：
更新日期：2012-06-01 00:00:00
abstract：:Bone marrow aspiration (BMA) and bone marrow trephine biopsy are important procedures for the diagnosis of hematological malignancies and nonmalignant diseases in children. During BMA, bone marrow particles are obtained for analysis including microscopic morphologic evaluations and differential counts. During a trephi...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：10.1093/pch/13.6.499
更新日期：2008-07-01 00:00:00
abstract：:The management of patients with headaches is a major component of every paediatric practice. In a nationally representative sample of Canadian adolescents, it was found that 26.6% of those 12 to 13 years of age and 31.2% of those 14 to 15 years of age reported that they experienced headaches at least once per week.The...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：10.1093/pch/14.1.24
更新日期：2009-01-01 00:00:00
abstract：:Paediatric restless legs syndrome (RLS) treatment is important because RLS's associated sleep disturbance causes significant developmental-behavioural morbidity and impacts family well-being. RLS is associated with brain iron insufficiency and dopaminergic dysfunction. Diagnosis requires fulfillment of diagnostic crit...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：10.1093/pch/17.4.193
更新日期：2012-04-01 00:00:00
abstract：:Parents of children with type 1 diabetes commonly worry about the ability of school personnel to respond to their child's diabetes needs, and may feel anxious about the health, safety and inclusion of their child in school. Physicians may be confronted by parents' fears, anxieties and apprehension, and need to know ho...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：10.1093/pch/10.1.25
更新日期：2005-01-01 00:00:00
abstract：BACKGROUND:Child abuse and neglect (CAN) represents an international public health and societal problem, the extent and nature of which are inadequately understood. Child and youth protection programs (CYPPs), based in 16 Canadian paediatric academic health science centres, identify, manage, treat and prevent cases of ...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：
更新日期：2007-03-01 00:00:00
abstract：Objective:To examine changes in the awareness, use, feasibility, and barriers associated with the Canadian Physical Activity and Sedentary Behaviour Guidelines for Children and Youth ages 0-17 years in a sample of Canadian paediatricians, and to assess tools/resources developed by the Canadian Paediatric Society (CPS)....
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：10.1093/pch/pxx006
更新日期：2017-03-01 00:00:00
abstract：INTRODUCTION:In September 2005, the Alberta government introduced the daily physical activity (DPA) initiative, which requires that students from grades 1 to 9 be physically active in school for a minimum of 30 min per day. OBJECTIVE:To obtain information on whether and how the DPA initiative has been implemented in C...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：10.1093/pch/15.7.e19
更新日期：2010-09-01 00:00:00
abstract：:In Canada, cerebral palsy (CP) is the most common physical disability, affecting approximately 2 to 3 per 1,000 individuals. Paediatricians are sure to encounter and care for children with CP and their families. The role of the general paediatrician in caring for a child with CP is crucial, from diagnosis to providing...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：10.1093/pch/pxaa100
更新日期：2020-09-16 00:00:00
abstract：BACKGROUND:The optimal timing for changing intravenous (IV) administration sets that contain total parenteral nutrition (TPN), with and without lipids, in neonates remains unknown. OBJECTIVE:To determine whether decreasing the frequency of changing IV administration sets (>24 h versus every 24 h) in neonates increases...
journal_title：Paediatrics & child health
pub_type： 杂志文章,评审
doi：
更新日期：2012-11-01 00:00:00
abstract：:In Canada, the National Advisory Committee on Immunization systematically reviews the evidence for the effectiveness and safety of new and old vaccines, and sets a 'minimum' recommended schedule. However, in contrast to other industrialized countries where single, harmonized countrywide immunization schedules are de r...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：
更新日期：2011-01-01 00:00:00
abstract：:The harmful effects of child poverty are well documented. Despite this, progress in poverty reduction in Canada has been slow. A significant gap exists between what is known about eradicating poverty and its implementation. Paediatricians can play an important role in bridging this gap by understanding and advancing c...
journal_title：Paediatrics & child health
pub_type： 杂志文章,评审
doi：10.1093/pch/20.4.203
更新日期：2015-05-01 00:00:00
abstract：:While terms such as 'essential' and 'nonessential' used amidst the COVID-19 pandemic may serve a practical purpose, they also pose a risk of obstructing our view of the harmful indirect health consequences of this crisis. SARS-CoV-2 cases and deaths in children are minimal compared to adults, but the pandemic impacts ...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：10.1093/pch/pxaa077
更新日期：2020-08-01 00:00:00
abstract：:The present statement reviews the evidence for universal newborn hearing screening (UNHS). A systematic review of the literature was conducted using Medline and using search dates from 1996 to the third week of August 2009. The following search terms were used: neonatal screening AND hearing loss AND hearing disorders...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：10.1093/pch/16.5.301
更新日期：2011-05-01 00:00:00
abstract：:In the face of negative media attention, community members and Elders from the First Nation community of Maskwacis identified the importance of promoting community strengths and reframing perceptions of their community. Two research questions were addressed: (1) How do youth in Maskwacis view their community strengths...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：10.1093/pch/pxx178
更新日期：2018-07-01 00:00:00
abstract：Objectives:Children with attention deficit/hyperactivity disorder (ADHD) are frequently treated with psycho-stimulant agents causing a modest but significant increase in blood pressure and heart rate. The objective of this study was to define blood pressure characteristics in children with ADHD treated with a variety o...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：10.1093/pch/pxx207
更新日期：2018-09-01 00:00:00
abstract：:Mitigating the harmful effects of adverse social conditions is critical to promoting optimal health and development throughout the life course. Many Canadians worry over food access or struggle with household food insecurity. Public policy positions breastfeeding as a step toward eradicating poverty. Breastfeeding ful...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：10.1093/pch/pxx067
更新日期：2017-07-01 00:00:00
abstract：:There is a growing focus in the medical community on de-escalating medical treatments where appropriate; however, specific efforts to reduce medication burden in patients with polypharmacy has largely been targeted toward adult populations. Polypharmacy increases the risk of adverse drug reactions in children, and tha...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：10.1093/pch/pxy188
更新日期：2019-08-01 00:00:00
abstract：:A 1992 meta-analysis did not find enough evidence to recommend one method of umbilical cord care as the 'best'. However, certain agents were deemed acceptable including triple dye, silver sulfadiazine and antibiotic ointments. In this paper, the authors sought to discover whether there was now evidence to support one ...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：10.1093/pch/4.2.105
更新日期：1999-03-01 00:00:00
abstract：:Nontyphoidal Salmonella (NTS) infections are primarily transmitted by contaminated food or water or contact with carrier animals (particularly reptiles), and present with diarrhea. Antibiotics do not decrease the severity or duration of diarrhea and may increase the incidence of NTS carriage, so they should only be us...
journal_title：Paediatrics & child health
pub_type： 杂志文章,评审
doi：10.1093/pch/pxy199
更新日期：2019-02-01 00:00:00
abstract：:The present article is intended to inform paediatricians about the associations between ambient air pollution and adverse health outcomes in children within the context of current epidemiological evidence.The majority of the current literature pertains to adverse respiratory health outcomes, including asthma, other re...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：
更新日期：2006-10-01 00:00:00
abstract：:Clinical trials in paediatric cancer continue to be a key factor in progress toward better treatment and prognosis. Paediatricians and family physicians may be asked by patients and families for their advice regarding participation in such trials. The significant advances in the success of treatment of paediatric canc...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：
更新日期：2006-03-01 00:00:00
abstract：:Medically unexplained symptoms in young people can present a challenge for primary care physicians to manage. Despite the prevalence of this clinical problem, physicians feel ill-equipped to deal with it. Families may attribute symptoms to an organic cause, despite the absence of identified pathology, and often resist...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：
更新日期：2008-07-01 00:00:00
abstract：:Widespread varicella vaccination in Canada since 2007 has changed the epidemiology of chickenpox, with a significant decline in varicella-related hospitalizations. However, there will always be a varicella-susceptible population because of immune-compromising treatments or conditions and/or parental vaccine refusal. T...
journal_title：Paediatrics & child health
pub_type： 杂志文章,评审
doi：10.1093/pch/pxy096
更新日期：2018-09-01 00:00:00
abstract：BACKGROUND:Health care professionals (HCPs) may be involved in counselling women after an antenatal diagnosis of various fetal anomalies. Many pregnant women consider termination of pregnancy (TOP) after antenatal diagnosis of various fetal anomalies. Little is known, however, about the attitudes of HCPs regarding TOP ...
journal_title：Paediatrics & child health
pub_type： 杂志文章
doi：10.1093/pch/17.8.e86
更新日期：2012-10-01 00:00:00
