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Infant Urgent Care Decisions Vary Widely Across Hospitals

Studies look at treatment of fever, use of ibuprofen to prevent patent ductus arteriosus

MONDAY, July 20 (HealthDay News) -- Decisions about newborn care, especially those made in urgent situations, vary among hospitals, pointing to the need for clear clinical guidelines and careful weighing of treatment goals and side effects, according to two studies published online July 20 in Pediatrics.

In one study, Enrico Zecca, M.D., of Catholic University of the Sacred Heart in Rome, and colleagues evaluated data on 418 infants born at less than 30 weeks gestation, who were given ibuprofen to prevent patent ductus arteriosus, and a control group of 288 infants not given ibuprofen. The researchers found the ibuprofen group had a significantly higher serum bilirubin level than the control group and required more phototherapy for jaundice from hyperbilirubinemia. The study authors advised clinicians to "balance the benefits of ibuprofen against its possible side effects."

In a second study, Ran D. Goldman, M.D., of British Columbia Children's Hospital in Vancouver, Canada, and colleagues collected data on infants up to 90 days old who presented with fever at six pediatric emergency departments, and assessed variations in treatment. While the emergency departments had similar rates for blood and urine testing, there was inconsistency in the rates for respiratory virus testing, lumbar puncture, and chest radiography. For the 55 percent of infants receiving antibiotics, there were significant practice variations in the types and number of antibiotics prescribed.

"Future studies should be designed to elucidate the reasoning and rationale used by physicians for their management decisions, to devise knowledge translation strategies for health care providers," the authors of the second study write.

Abstract - Zecca
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Abstract - Goldman
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