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AAP Grand Rounds 20:25-26 (2008) Pneumococcal Immunization: a NICE OutcomeSource: Waddle E, Jhaveri R. Outcomes of febrile children without localizing signs post-pneumococcal conjugate vaccine. Arch Dis Child. Published online June 6, 2008; doi:10.1136/adc.2007.130583
Researchers from Duke University retrospectively compared rates of occult bacteremia (OB) and urinary tract infection (UTI) in children 3–36 months of age with fever without localizing signs (FWLS) in the pre- and post-conjugate pneumococcal vaccine (PCV7) eras to evaluate current guidelines1–4 and determine the most appropriate management. The charts of all children presenting at a single academic pediatric emergency department (ED) were reviewed. For the purposes of this study, pre-PCV7 refers to the years 1997–1999 and post-PCV7 refers to 2001–2004. As PCV7 was licensed in February 2000, that was considered a transitional year and patients seen during that year were excluded.
Patients were classified as having FWLS and eligible for the study if
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