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Antimicrobial stewardship

Accurate diagnosis of group A streptococcal (GAS) pharyngitis is important, particularly in populations where acute rheumatic fever and post -streptococcal glomerulonephritis have a high incidence. There is also concerne about the over diagnosis of GAS infections and over use of antibiotics contributing to increasing antibiotic resistance. A paper by Tanz R et al. [Pediatric Infectious Disease Journal 2019;38(8)769–774 doi: 10.1097/INF.0000000000002293] illustrates the problem of over diagnosis when using highly sensitive molecular tests where carriage of GAS could be misinterpreted as causing a pharyngitis. This short paper illustrates that the use of a particularly highly sensitive test was more likely than throat cultures to yield positive results in patients without GAS pharyngitis. The message for Lucina is: make sure you know about the limitations of the tests you use in your clinical practice.

Neuroimaging in children with complex febrile seizures

There is often parental pressure to investigate children who have had febrile seizures with neuroimaging. Children with complex febrile seizures (CFS) [multiple seizures in one febrile episode, focal seizures or seizures lasting greater then 15 minutes] are more likely to have intracranial pathology but once a child has recovered and has a normal neurological examination and the history is clear …

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