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This Month in Archives of Pediatrics and Adolescent Medicine
April 2003

This Month in Archives of Pediatrics & Adolescent Medicine

Arch Pediatr Adolesc Med. 2003;157(4):315. doi:10.1001/archpedi.157.4.315
Use of Complementary and Alternative Medicine by Children in the United States

Pediatricians report that many families seek complementary and alternative medicine therapies for their children, but no prior national surveys have been done on the extent of their use. In a nationally representative sample, Davis and Darden found that only 1.8% of children and adolescents younger than 18 years reported using alternative care practitioners in the previous year. Use of complementary and alternative medicine increased with patient age and was twice as common for children living in nonurban areas. In the United States, the use of complementary and alternative medicine appears to be uncommon.

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Risk of Bacteremia in Young Children With Pneumonia Treated as Outpatients

Although blood cultures are often performed as part of an evaluation of children with pneumonia, the risk of bacteremia in these children in the post–Haemophilus influenzae vaccine era is unclear. This study of 580 children aged 2 to 24 months found that only 9 children (1.6%) had cultures positive for bacteremia, and all cases were due to Streptococcus pneumoniae. Three fourths of these cases were caused by serotypes included in the currently available vaccine. The contamination rate for cultures was 1.9%, higher than the rate of true-positive results, underscoring the questionable utility of routine blood cultures.

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Descriptive Epidemiology of Infantile Cataracts in Metropolitan Atlanta, Ga, 1968-1998

Infantile cataract is an important cause of childhood visual impairment, requiring surgery before age 6 weeks to achieve optimal visual outcome. Data from the Metropolitan Atlanta Congenital Defects Program collected during a 30-year period demonstrated that the rate was 2 per 10 000 births. In most children cataracts occurred as an isolated birth defect, although only 62% of these were diagnosed before 6 weeks of age. The risk of cataracts was 6-fold higher in infants with very low birth weights compared with full-term infants. These findings indicate the need for improved detection of cataracts by pediatricians in the nursery and at early well-child visits.

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Acute Care and Antibiotic Seeking for Upper Respiratory Tract Infections for Children in Day Care

Children who attend day care are high consumers of antibiotics. Prior studies have suggested that physicians prescribe unnecessary antibiotics for upper respiratory tract infections for children who attend day care based on perceived pressure from parents and day care centers. This survey of parents and day care center staff for 211 Massachusetts children found that only 1.9% of parents reported pressure from day care center staff to seek antibiotics for their child. Parent-reported acute care seeking was not related to a day care center's policies or exclusion or physician clearance for these illnesses, and parents' beliefs about the efficacy of antibiotics were not related to day care center policies.

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