Pediatrics
-
Randomized Controlled Trial Clinical Trial
Use of dexamethasone in the outpatient management of acute laryngotracheitis.
Recent studies have demonstrated that a single intramuscular injection of dexamethasone (0.6 mg/kg) shortens the duration and severity of illness in hospitalized patients with acute viral laryngotracheitis (croup). Our objective was to determine if dexamethasone has a role in the outpatient management of patients with acute viral croup of moderate severity. ⋯ The use of dexamethasone in the outpatient management of viral croup was associated with a reduction in severity of illness within 24 hours after treatment. Patients with viral croup of moderate severity should be considered as candidates for the use of dexamethasone before discharge from the ED.
-
Randomized Controlled Trial Clinical Trial
Efficacy of 20- versus 10-day antimicrobial treatment for acute otitis media.
The purpose of this trial was to determine whether 20 days of antimicrobial treatment is more efficacious than 10 days of treatment for acute otitis media (AOM) in clearing middle ear effusion and preventing recurrences of AOM, and whether changing to a beta-lactamase-stable antimicrobial agent after the initial 10-day treatment with amoxicillin for AOM is advantageous. ⋯ More children were effusion free by the day 20 visit if given antimicrobial treatment for 20 days rather than for 10 days, but this advantage was present for only a short time; by the end of the 90-day study period, the treatment groups were comparable with regard to effusion status. Recurrence of AOM during the study period was not prevented by the additional 10 days of treatment. Routine use of an additional 10-day course of antimicrobial treatment is therefore not recommended if a child is symptom free after the initial 10 days of treatment for AOM.
-
Randomized Controlled Trial Clinical Trial
A randomized clinical trial of home intervention for children with failure to thrive.
To evaluate the efficacy of a home-based intervention on the growth and development of children with nonorganic failure to thrive (NOFTT). ⋯ Findings support a cautious optimism regarding home intervention during the first year of life provided by trained lay home visitors. Early home intervention can promote a nurturant home environment effectively and can reduce the developmental delays often experienced by low income, urban infants with NOFTT: Subsequent investigations of home intervention should consider alternative options for toddlers with NOFTT:
-
Randomized Controlled Trial Clinical Trial
Use of a single solution for oral rehydration and maintenance therapy of infants with diarrhea and mild to moderate dehydration.
To compare the efficacy of two commonly used solutions in the rehydration of infants with mild to moderate dehydration caused by acute diarrhea in the United States. ⋯ The two maintenance oral electrolyte solutions (Pedialyte and Infalyte) most commonly used in the United States are effective as rehydration solutions for infants with mild to moderate dehydration. We speculate that a strategy for oral rehydration therapy in the United States, based on the use of a single solution during the rehydration and maintenance phase, might gain additional acceptance by practicing pediatricians and family physicians.
-
Randomized Controlled Trial Clinical Trial
Buffered lidocaine: analgesia for intravenous line placement in children.
To evaluate the effectiveness of intradermal buffered lidocaine as analgesia before intravenous line (i.v.) placement in children. ⋯ Use of intradermal buffered lidocaine is an effective way to diminish the pain of i.v. line placement in children 8 to 15 years of age. There was no difference in i.v. success rate in this study; however, larger numbers of patients would be required to detect statistically significant differences. We recommend the routine use of intradermal buffered lidocaine for analgesia before i.v. line placement in older children in all but emergent situations.