Posted by ano from IP 18.104.22.168 on December 02, 2015 at 11:02:43:
In Reply to: Pediatric Pneumonia and URI in general posted by blue on November 26, 2015 at 19:58:12:
I understand your concern regarding missing those few cases with bacterial pneumonia but presenting like viral or those with superimposed bacterial infection. But i totally disagree with you. Right now the antibiotic resistance of these bugs to antibiotics is increasing in an alarming rate. What used to be simple penicillin sensitive bugs are now resistant.
Soon we will run out of weapon to combat these bacteria. When that happens all you can do is watch your patient die and no one can do anything about it.
I think the key in catching those few cases 1. Physician's good clinical skills/eye. If you are not sure (and in most cases it might not be), you have to educate the parents/patient to follow up if this doesn't get better or get worse.Tell them what signs and symptoms to watch out for. 2. Patients/Parents should be responsible enough to follow your
instructions and get involve with their management.
3. Judicious use of antibiotic will ensure its prolong effectiveness against these bugs.
Overall It depends on how the patient looks to you. If the patient looks bad then order some test if not assume viral and follow up. It depend on your clinical experience to tell which one looks bad one who is not. I guess thats why they said we learn from each case that we see. Thats my opinion about it.
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