| The need for a second dose of ceftriaxone in febrile infants age 4-8 weeks. | |
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MedLine Citation:
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PMID: 10843028 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine if a second intramuscular injection of ceftriaxone was necessary in febrile infants who meet low-risk criteria for outpatient therapy. SETTING: Children's Hospital Emergency Department. PATIENTS: Febrile infants 4-8 weeks of age. METHODS: Outpatient treatment criteria included non-toxic appearance, no identifiable source for infection on physical examination, CSF WBC > or = 10/mm3, peripheral WBC < or = 15,000/mm3, normal UA, and normal chest radiograph study, if obtained. Additional requirements included a reliable caretaker and re-evaluation in 24 hours. Infants who met these criteria received intramuscular ceftriaxone 50 mg/kg with instructions to follow-up in 24 hours. At the follow-up visit, infants with no identifiable source for infection and negative cultures received a second dose of intramuscular ceftriaxone and were discharged. Cultures were read at 48 hours and at the conclusion of the study. Medical records were reviewed to identify delayed complications. RESULTS: 172 infants were enrolled. The mean age was 45 days. All CBC, UA, CSF analyses were normal. Chest radiographs were obtained in 56 (30%) infants; all were normal. One (.05%) patient was admitted at the follow-up visit. The mean time to follow-up was 25 hours. Two positive cultures were identified at the re-evaluation visit; one blood culture grew Salmonella and a urine culture grew E. coli. The CSF cultures were all negative at follow-up and remained negative. CONCLUSION: Febrile infants 4-8 weeks of age who meet outpatient therapy criteria and have negative cultures and no identifiable source for infection at 24 hours may not require the second dose of intramuscular ceftriaxone. |
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Authors:
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S E Allen; C M Walsh-Kelly; H H Hennes |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: WMJ : official publication of the State Medical Society of Wisconsin Volume: 99 ISSN: 1098-1861 ISO Abbreviation: WMJ Publication Date: 2000 Apr |
Date Detail:
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Created Date: 2000-09-05 Completed Date: 2000-09-05 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9716054 Medline TA: WMJ Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 60-2 Citation Subset: IM |
Affiliation:
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Emergency Medicine Section, Cincinnati Children's Hospital, OH, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Ambulatory Care Ceftriaxone / administration & dosage*, therapeutic use Cephalosporins / administration & dosage*, therapeutic use Drug Administration Schedule Fever / drug therapy* Humans Infant Infant, Newborn Injections, Intramuscular Patient Care Management Prospective Studies |
| Chemical | |
Reg. No./Substance:
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0/Cephalosporins; 73384-59-5/Ceftriaxone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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