On March 31 Matt White provided a nuanced and evidence-based review of three common controversies in pediatrics. The awesome summary created by Kristen Weersink below doesn’t quite do it justice. However, if you missed the presentation live, this summary is a great start to get you thinking about these common presentations. Next time you are working a shift with Matt pick his brain. Believe me, he’s got an insane amount of knowledge to drop.
Side note: It’s possible you’ll hear Matt referred to as Donald Trump in the coming months…you had to be there! There was lots of laughter and fun at this edition of grand rounds including an animated analysis of antibiotic consumption in Newfoundland – I’m sure you can guess who had the room belly laughing. The presenter and audience were in fine form, as usual.
Hope to see you all out for the next one! In the meantime, feel free to ask any questions or discuss pediatric controversies below.
To download a PDF copy of this infographic click here.
1. Vallancourt et al. Repeated emergency department visits among children admitted with meningitis or septicemia: a population-based study. 2015. Annals of EM. 65;6. 625.
2. Huppler et al. Performance of low-risk criteria in the evaluation of young infants with fever: review of the literature. Pediatrics, 2010. 125;2. 228.
3. Baraff, L. Management of infants and young children with fever without a source. Pediatric Annals. 2008. 37;10. 673.
4. Green et al. Sick Kids Look Sick. Pediatrics. 2015. 65;6. 655.
5. ACEP Clinical Policy. Clinical Policy for children younger than 3 years presenting to the ED with Fever. Annals of Emergency Medicine. 2003. 42;4. 530.
6. Green, S. Evaluation styles for well-appearing febrile children: Are you a “risk minimizer” or a “test-minimizer.” Annals of Emergency Medicine, 1999. 33;2. 211.
7. Baraff et al. Practice Guideline for the Management of Infants and Children 0 to 36 months of age with fever without a source. Annals of Emergency Medicine. 1993. 22;7. 1198.
8. Watson et al. Scope and epidemiology of pediatric sepsis. Ped. Critical Care. 2005. 6;3. 3.
9. Wilkinson et al. Prevalence of occult bacteria in children aged 3 to 36 months presenting to the ED with fever in the post pneumococcal conjugate vaccine era. Academic EM. 2009. 16;3. 220
1. Spiro, D., Tay, KY., Arnold, D. Dziura, J. Baker, M., Shapiro, E. Wait-and-See Prescription for the Treatment of Acute Otitis Media. JAMA, 2006, 296; 10. 1235-1241
2. Tahtinen et al. A Placebo-Controlled Trial of Antimicrobial Treatment for Acute Otitis Media. NEJM. 2011. 364;2. 116-126.
3. Venekamp RP. Antibiotics for Acute Otitis Media in Children. Cochrane Review, 2015.
4. Thompson et al. Effect of antibiotics for otitis media on mastoiditis in children: a retrospective cohort study using the UK general practice research database. Pediatrics, 2009. 123;424.
5. Le Saux et al. A randomized, double-blind, placebo-controlled non inferiority trial of amoxicillin for clinically diagnosed acute otitis media in children 6 months to 5 years of age. CMAJ. 2005; 173;3. 335.
6. Garrison et al. High-dose versus standard-dose amoxicillin for acute otitis media. Annals of Pharmacotherpay. 2004. 28;15.
7. Liberathal et al. CPG: The Diagnosis and Management of Acute Otitis Media from the AAP. Pediatrics. 131;3;964.
8. Hoberman et al. Treatment of acute otitis media in children under 2 years of age. NEJM. 2011;365.2. 105.
9. Le Saux et al. CPS: Management of acute otitis media in children six months of age and older. Pediatric Child Health 2016;21;1. 39-44.
1. Shaw, K. Call for a rational approach for testing for urinary tract infection as a source of fever in infants. Annals of EM. 2013. 61;5. 566.
2. Newman et al. Pediatric Urinary Tract Infection: does the evidence support aggressively pursuing the diagnosis? Annals of EM. 2013. 61;5. 559.
3.3Robinson et al. CPS Urinary tract infection in infants and children: diagnosis and management. Ped Children Health, 2014. 19;6. 315.
4. AAP Guideline. Urinary Tract Infection: CPG for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics, 2011, 128;3. 595.
5. Davies, D. Bag urine specimens still not appropriate in diagnosing urinary tract infections in infants. Ped Children Health. 2004. 9;6. 377
6. Schroeder et al. Diagnostic accuracy of the urinalysis for UTI in infants < 3 months of age. Pediatrics. 2015, 135;6, 968.
7. Ralston et al. Occult Serious Bacterial Infection in Infants Younger than 60-90 days with bronchiolitis: a systemic review. Arch Pediatric Adolesc Med. 2011. 165;10. 951.
8. Elkhunovich et al. Assessing the utility of urine testing in febrile infants aged 2 to 12 months with bronchiolitis. Pediatric Emergency Care. 2015. 31;9. 616.
9. Henadaus et al. Risk of urinary tract infection in infants and children with acute bronchiolitis. Pediatric Child Health. 2015. 20;5.25.