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Indian Pediatr 2009;46:1 110 |
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K Rajeshwari
Email:
[email protected] |
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Antibiotic prophylaxis for UTI in
children (N Eng J Med 2009; 361(18):1748-59) |
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Antibiotics are widely administered to children with the intention of
preventing urinary tract infection, but adequately powered,
placebo-controlled trials regarding efficacy are lacking. This study from
four Australian centers examined whether low-dose, continuous oral
antibiotic therapy prevents urinary tract infection in predisposed
children. Children under 18 years who had had one or more
microbiologically proven urinary tract infections were randomly assigned
to receive either daily trimethoprimsulfamethoxazole suspension (2 mg of
trimethoprim plus 10 mg of sulfamethoxazole per kg of body weight) or
placebo for 12 months. The primary outcome was microbiologically confirmed
symptomatic urinary tract infection. The median age at entry was 14
months; 64% of the patients were girls, 42% had known vesicoureteral
reflux (at least grade III in 53% of these patients), and 71% were
enrolled after the first diagnosis of urinary tract infection. Long-term,
low-dose trimethoprim-sulfamethoxazole was associated with a decreased
number of urinary tract infections in predisposed children. During the
study, urinary tract infection developed in 36 of 288 patients (13%) in
the group receiving trimethoprim-sulfamethoxazole (antibiotic group) and
in 55 of 288 patients (19%) in the placebo group. The treatment effect
appeared to be consistent but modest across subgroups.
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Etiology of pleural effusion in children
(Turk J Pediatr 2009 ; 51(3): 214-9) |
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Pleural effusions in children present a changing profile over time, both
in terms of etiological subgroups and causative microorganisms in
parapneumonic effusions. This retrospective study from Turkey aimed to
review pediatric pleural effusions in a large cohort over a 29-year
period, with special emphasis on the etiological subgroups and
microbiological causes of parapneumonic effusions. The medical records of
492 pediatric patients were reviewed for a comparison of subgroups of
pleural effusions and microbiological causes of parapneumonic effusions
between three decades. Parapneumonic effusions made up 77.4% of the group.
Tuberculous pleurisy decreased, but malignant effusions doubled in number
over time. A causative microorganism was identified in 34.6% overall, with
Staphylococcus aureus and Streptococcus pneumoniae being the
two most common. Relative frequency of S. aureus decreased, whereas
pneumococci and Haemophilus influenzae were more frequent in recent
years. Periodic review of the causes of pleural effusions and antibiotic
sensitivity spectrum of the various agents causing these effusions will
help in deciding the antibiotic policy for the same.
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Influenza A (H1N1) and vaccination (MMWR
Morb Mortal Wkly Rep 2009; 58(39):1100-1) |
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On September 15, 2009, four influenza vaccine manufacturers received
approval from the Food and Drug Administration for use of influenza A
(H1N1) 2009 monovalent influenza vaccines in the prevention of influenza
caused by the 2009 pandemic influenza A (H1N1) virus. Both live,
attenuated and inactivated influenza A (H1N1) 2009 monovalent vaccine
formulations are available; each contains the strain
A/California/7/2009(H1N1)pdm. None of the approved influenza A 2009 (H1N1)
monovalent vaccines or seasonal influenza vaccines contains adjuvants.
Children aged 6 months to 9 years receiving influenza A (H1N1) 2009
monovalent vaccines should receive 2 doses, with doses separated by
approximately 4 weeks; persons aged
³10 years should
receive 1 dose.
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