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The Pediatric Forum
April 1999

E-mail and Medical Education

Arch Pediatr Adolesc Med. 1999;153(4):430. doi:

The report on the use of e-mail to teach emergency medicine to pediatric residents1 included an example question regarding the appropriate administration of rabies immune globulin for postexposure prophylaxis following a bat bite. The answer to the example question as stated in the report is incorrect. In January 1998 the Advisory Committee on Immunizations Practices of the Centers for Disease Control and Prevention published new recommendations that as much as possible of the full dose (20 IU/kg of body weight) of rabies immune globulin should be infiltrated into and around the wound(s), and any remaining volume should be administered intramuscularly at an anatomical site distant from vaccine inoculation.2 These recommendations were detailed more completely in January 1999, 3 and updated in the 1994 source cited in the example questions.4

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