This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Improved Outcome in Children Treated With Antibiotics

Elizabeth R. Woods, MD, MPH; James L. Merola, PhD; William G. Bithoney, MD; Howard Spivak, MD; Paul H. Wise, MD, MPH

Am J Dis Child. 1990;144(11):1195-1199.

Abstract
• We undertook a study of 414 bacteremic patients (167 with Haemophilus influenzae and 247 with Streptococcus pneumoniae bacteremia) to evaluate their clinical presentation, laboratory and clinical results, and subsequent outcomes. Patients with H influenzae bacteremia were more likely to have soft-tissue foci, poorer clinical appearance at presentation, and be at higher risk for subsequent serious focal infections, persistent bacteremia, and subsequent hospital admissions than patients with S pneumoniae. Patients with H influenzae bacteremia had a 21.1-fold increase in risk of meningitis (95% confidence interval [CI] of 3.8 to 78.0) compared with those with S pneumoniae. The odds ratio for initial lumbar puncture was 5.25(95% Cl [1.1-23.6]). Ambulatory patients treated with antibiotics at presentation were less likely to develop new serious soft-tissue infections, persistent bacteremia, or to require subsequent hospital admissions than untreated patients. The effect of treatment was greater for patients with S pneumoniae than those with H influenzae. Careful follow-up and reevaluation of patients with presumptive bacteremia is essential because treated and untreated patients can still develop serious soft-tissue infections.

(AJDC. 1990;144:1195-1199)

Author Affiliations
From the Division of Adolescent/Young Adult Medicine (Dr Woods), the Department of Medical Information (Dr Merola), and the Comprehensive Child Health Program (Dr Bithoney), Children's Hospital; the Department of Pediatrics, Harvard Medical School (Drs Woods, Bithoney, and Wise); The Joint Program in Neonatology, Brigham and Women's Hospital (Dr Wise); and Health Promotion Sciences, Massachussetts Department of Public Health (Dr Spivak), Boston, Mass.

Footnotes
Accepted for publication May 10, 1990.

Presented in part before the meeting of the Ambulatory Pediatric Association, Washington, DC, May 5, 1983.

Reprint requests to Division of Adolescent Medicine, Children's Hospital, 300 Longwood Ave, Boston, MA 02115 (Dr Woods).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Reevaluation of Outpatients With Streptococcus pneumoniae Bacteremia
Bachur and Harper
Pediatrics 2000;105:502-509.
ABSTRACT | FULL TEXT  

Urinary Tract Infection Controversy and Questions
McMahon Jr; et al.
Pediatrics 1998;101:731-731.
FULL TEXT  

Management of the Young Febrile Child: A Commentary on Recent Practice Guidelines
Kramer
Pediatrics 1997;100:128-128.
FULL TEXT  

Do Oral Antibiotics Prevent Meningitis and Serious Bacterial Infections in Children With Streptococcus pneumoniae Occult Bacteremia? A Meta-analysis
Rothrock et al.
Pediatrics 1997;99:438-444.
ABSTRACT | FULL TEXT