The potentially negative side of newborn screening is the detection of heterozygous infants and false-positive results. Posttest counseling and communication with families is critical in reducing possible harm caused by these results. Farrell et al's survey of state programs found that less than half the programs in the United States provide counseling after false-positive results or for the families of heterozygous infants. Few states track the quality of their counseling, and the best practices for postscreening counseling are not yet evident.
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Febrile urinary tract infections in children are common and have the potential for long-term sequelae. In a randomized controlled trial of children between the ages of 6 months and 12 years with febrile urinary tract infections, Baker and colleagues examined the benefit of adding a single dose of ceftriaxone to a 10-day course of oral trimethoprim-sulfamethoxazole compared with oral therapy alone. After 48 hours, there was no difference in urine sterilization rate, degree of clinical improvement, or subsequent admission rate. Parenteral ceftriaxone appears to add little to the effectiveness of oral therapy.