A Randomized Study of Outpatient Treatment with Ceftriaxone for Selected Febrile Children with Sickle Cell Disease

• Published in: The New England journal of medicine Vol. 329; no. 7; pp. 472 - 476
• Main Authors: Wilimas, Judith A, Flynn, Patricia M, Harris, Sylvia, Day, Sara W, Smith, Ralph, Chesney, P. Joan, Rodman, John H, Eguiguren, Jose M, Fairclough, Diane L, Wang, Winfred C
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 12-08-1993
• Subjects: Age; Ambulatory Care; Anemia, Sickle Cell - drug therapy; Antibiotics; Bacteremia - prevention & control; beta-Thalassemia - drug therapy; Biological and medical sciences; Body weight; Ceftriaxone; Ceftriaxone - therapeutic use; Child; Child, Preschool; Children; Children & youth; Dehydration; Emergency medical care; Female; Fever; Haemophilus influenzae; Hematologic and hematopoietic diseases; Hematology; Hemoglobin; Hemoglobin SC Disease - drug therapy; Hospitalization; Humans; Illnesses; Infant; Intravenous administration; Laboratories; Male; Medical sciences; Mortality; Oncology; Other diseases. Hematologic involvement in other diseases; Pain; Parents & parenting; Patients; Pediatrics; Pilot Projects; Prospective Studies; Random Allocation; Sepsis; Sickle cell anemia; Sickle cell disease; Streptococcus infections; Vaccines; Human; Sickle cell anemia; Hemopathy; Fever; Streptococcus pneumoniae; Infection; Streptococcaceae; Antibiotic; Chemotherapy; Treatment; Streptococcal infection; Bacteriosis; Bacteria; Micrococcales; Complication; Ambulatory; Child; Pneumococcal infection
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM199308123290705

Despite the use of pneumococcal vaccine and prophylactic oral penicillin, septicemia due to infection with Streptococcus pneumoniae remains a major cause of morbidity and mortality among young children with sickle cell disease
1
. Traditionally, febrile children with sickle cell disease have routinely been hospitalized for the prompt administration of high-dose parenteral antibiotics to treat potentially fatal septicemia
2
. Each such admission represents a disruption in the lives of the patients, who may be psychologically affected by repeated hospitalizations, and their parents, who may lose time from work and find their jobs in jeopardy. Furthermore, the expenditure of health care resources . . .