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首页> 外文期刊>Hospital pediatrics. >Should I prescribe antibiotics after draining an abscess in a young child? Should I pack his wound? Do I prescribe decolonizing measures?Should I routinely prescribe antibiotic prophylaxis at discharge after UTI?IV antibiotics in febrile UTI: how long is long enough?Should I avoid steroids in wheezing patients whom I suspect also have bacterial pneumonia?
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Should I prescribe antibiotics after draining an abscess in a young child? Should I pack his wound? Do I prescribe decolonizing measures?Should I routinely prescribe antibiotic prophylaxis at discharge after UTI?IV antibiotics in febrile UTI: how long is long enough?Should I avoid steroids in wheezing patients whom I suspect also have bacterial pneumonia?

机译：小孩子排脓后我应该开抗生素吗？我应该收拾他的伤口吗？我是否应采取非殖民化措施？是否应在UTI出院后常规开抗生素预防？IV高热性UTI中的抗生素：足够长的时间？我应该避免在喘息患者中怀疑类固醇性肺炎的患者使用类固醇？

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You are asked to admit a previously healthy 15-month-old male with an abscess on his right buttock. The induration and erythema are about 5 and 7 cm respectively, and his maximum temperature has been 100F. His older brother has had two similar abscesses. How would you approach this patient? Incision and drainage are clearly indicated, but what about antibiotics? Should the wound be packed? Should the child be decolonized? How?Classically, antibiotics have not been prescribed once an abscess has been drained; however, with the emergence of community associated MRSA (CA-MRSA) many have advocated antibiotics. There is also the concern for a cellulitic component to these processes in children. Two recent studies have addressed this question in pediatric populations. In a randomized, double-blind, controlled trial, Chen et al. compared clindamycin to cephalexin, assuming that clindamycin would be superior because of its efficacy against CA-MRSA.1 The primary outcome was clinical improvement at 48 to 72 hours, and the secondary outcome was resolution at 7 days. Participants were 6 months to 18 years old who presented to the ER with an abscess, furuncle, or carbuncle in which outpatient management was expected, and received a 7-day course of either cephalexin (40mg/kg/day divided three times a day) or clindamycin (20mg/kg/day divided three times a day). Indeed, 69% of the patients had MRSA cultured from their wounds. By 48 to 72 hours, 94% of subjects in the cephalexin arm and 97% of patients in the clindamycin arm were improved (p = 0.50). There was no association between gender, size of erythema or induration, location, or type of drainage procedure on primary outcome. There was a significantly lower rate of improvement at 48 to 72 hours among participants aged 1 year (p = 0.004) and those with fever (p = 0.03). In addition, only …
机译：>您被要求接纳一个以前健康的15个月大男性，其右臀部有脓肿。硬结和红斑分别约为5厘米和7厘米，他的最高温度为100F。他的哥哥有两次类似的脓肿。您将如何对待这个病人？切口和引流清楚地表明了，但是抗生素呢？伤口应该包装吗？孩子应该被非殖民化吗？通常，一旦排空脓肿，就不会开抗生素处方。但是，随着社区相关MRSA（CA-MRSA）的出现，许多人提倡使用抗生素。儿童中这些过程的纤维素成分也令人担忧。最近的两项研究已经解决了小儿人群的这一问题。 Chen等在一项随机，双盲，对照试验中。将克林霉素与头孢氨苄进行比较，认为克林霉素因其对CA-MRSA的疗效会更好。1主要结果是在48到72小时时临床改善，次要结果是在7天后得到缓解。参加者为6个月至18岁，在急诊室出现脓肿，fur或肿，预期可进行门诊治疗，并接受了7天的任一种头孢氨苄治疗（40mg / kg /天，每天分三次）或克林霉素（20mg / kg /天，一天三次）。确实，有69％的患者从伤口上培养了MRSA。到48至72小时时，头孢氨苄组的94％的受试者和克林霉素组的97％的患者得到了改善（p = 0.50）。在主要结局方面，性别，红斑大小或硬结，位置或引流方法类型之间没有关联。年龄<1岁的参与者（p = 0.004）和发烧的参与者（p = 0.03）在48至72小时的改善率显着降低。此外，只有…

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