Asunto(s)
Traumatismos de la Rodilla/diagnóstico , Traumatismos en Atletas/diagnóstico , Traumatismos en Atletas/terapia , Bursitis/diagnóstico , Bursitis/terapia , Trastornos de Traumas Acumulados/diagnóstico , Trastornos de Traumas Acumulados/terapia , Fracturas Óseas/diagnóstico , Fracturas Óseas/terapia , Humanos , Traumatismos de la Rodilla/terapia , Articulación de la Rodilla/anatomía & histología , Anamnesis , Osteocondrosis/diagnóstico , Osteocondrosis/terapia , Síndrome de Dolor Patelofemoral/diagnóstico , Síndrome de Dolor Patelofemoral/terapia , Examen FísicoAsunto(s)
Gastroenteritis/terapia , Enfermedad Aguda , Antidiarreicos/administración & dosificación , Preescolar , Terapia Combinada , Deshidratación/terapia , Diagnóstico Diferencial , Diarrea Infantil/etiología , Diarrea Infantil/terapia , Conducta Alimentaria , Fluidoterapia/métodos , Gastroenteritis/etiología , Humanos , Lactante , Admisión del Paciente , Probióticos/administración & dosificación , Infecciones por Rotavirus/diagnóstico , Infecciones por Rotavirus/terapia , Vómitos/terapia , Zinc/administración & dosificaciónRESUMEN
OBJECTIVES: To determine the antibiotic prescribing practices of pediatric residents and assess how they acquire knowledge leading to prescribing behaviors. METHODS: We performed a cross-sectional electronic survey of all pediatric residents at the Children's National Medical Center and Nicklaus Children's Hospital, assessing antibiotic prescribing patterns for common pediatric infections, use of antibiograms, and factors influencing antibiotic choice. RESULTS: Eighty-five surveys (45%) were returned complete and included in the analysis. Increased deviations from clinical guideline recommendations were observed for antibiotic treatments of sinusitis and community-acquired pneumonia as compared with otitis media and group A streptococcal pharyngitis. Only 57% of residents reported having used antibiograms. General pediatric inpatient attending physicians were identified as the most influential source for house staff antibiotic knowledge. CONCLUSIONS: Results illustrate the need for better promotion and integration of clinical guidelines with antibiograms when developing antibiotic education programs for residents in training. In addition, pediatric hospitalists should play an active role in the implementation of these programs and can provide valuable insight into the development of educational programs in conjunction with graduate medical education divisions.
Asunto(s)
Programas de Optimización del Uso de los Antimicrobianos/métodos , Prescripciones de Medicamentos/normas , Internado y Residencia , Pediatría , Pautas de la Práctica en Medicina , Estudios Transversales , Prescripciones de Medicamentos/estadística & datos numéricos , Encuestas de Atención de la Salud , HumanosAsunto(s)
Faringitis , Antibacterianos/uso terapéutico , Infecciones Bacterianas/complicaciones , Infecciones Bacterianas/diagnóstico , Infecciones Bacterianas/tratamiento farmacológico , Niño , Diagnóstico Diferencial , Humanos , Faringitis/complicaciones , Faringitis/diagnóstico , Faringitis/tratamiento farmacológico , Infecciones del Sistema Respiratorio/complicaciones , Infecciones del Sistema Respiratorio/diagnóstico , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Virosis/complicaciones , Virosis/diagnóstico , Virosis/tratamiento farmacológicoRESUMEN
An alcohol-naive 16-year-old male is presented with alcohol-induced atrial fibrillation. Past medical history, review of systems, and presentation were all otherwise benign. Atrial fibrillation occurred early in the intoxication at an alcohol level slightly higher than the legal limit for intoxication (153 mg/dL). His complete cardiac evaluation was otherwise normal. The atrial fibrillation was not treated aggressively and resolved as the alcohol level quickly fell to zero, consistent with his "nonalcoholic" metabolism. Complete follow-up found the adolescent with no evidence of cardiac or other disease.