Comparison of Empiric Antibiotics for Acute Osteomyelitis in Children.

Objectives: Broad-spectrum antibiotics are commonly used for the empiric treatment of acute hematogenous osteomyelitis and often target methicillin-resistant (MRSA) with medication-associated risk and unknown treatment benefit. We aimed to compare clinical outcomes among patients with osteomyelitis who did and did not receive initial antibiotics used to target MRSA.

Methods: A retrospective cohort study of 974 hospitalized children 2 to 18 years old using the Pediatric Health Information System database, augmented with clinical data.

Identifying Pediatric Severe Sepsis and Septic Shock: Accuracy of Diagnosis Codes.

Objectives: To evaluate accuracy of 2 established administrative methods of identifying children with sepsis using a medical record review reference standard.

Study Design: Multicenter retrospective study at 6 US children's hospitals. Subjects were children >60 days to <19 years of age and identified in 4 groups based on International Classification of Diseases, Ninth Revision, Clinical Modification codes: (1) severe sepsis/septic shock (sepsis codes); (2) infection plus organ dysfunction (combination codes); (3) subjects without codes for infection, organ dysfunction, or severe sepsis; and (4) infection but not severe sepsis or organ dysfunction.

Delay discounting by depressed and non-depressed adolescent smokers and non-smokers.

Background: Both delay discounting and depression are risk factors for cigarette smoking during adolescence. However, very little research has explored associations between these variables in adolescent smokers and non-smokers.

Methods: Eighty adolescents were recruited based on depression status (depressed and non-depressed) and smoking status (smokers and non-smokers) to form four groups (n=20 per group).

Rapid implementation of evidence-based guidelines for imaging after first urinary tract infection.

Background And Objectives: The American Academy of Pediatrics published a new guideline for management of first urinary tract infection (UTI) in children aged 2 to 24 months in September 2011. The imaging evaluation changed from the previous guideline to recommend voiding cystourethrogram (VCUG) only for patients with an abnormal renal and bladder ultrasound (RBUS). The objective was to decrease the proportion of guideline-eligible children with a normal RBUS who underwent VCUG from median of 92% for patients treated as inpatients and 100% for patients treated in the emergency department to 5% in both settings.

Antithrombin concentrate use in children: a multicenter cohort study.

Objective: To describe the off-label use of antithrombin concentrate in tertiary care pediatric hospitals across the US.

Study Design: This is a retrospective, multicenter, cohort study of 4210 admissions of children younger than 18 years of age who received antithrombin concentrate between 2002 and 2011 within the Pediatric Health Information System administrative database. An on-label admission was defined as an admission with an International Classification of Diseases diagnostic code for a primary hypercoagulable state; admissions without this code were classified as off-label.