Pediatric Fever Protocols

There have been several attempts at building protocols for pediatric fever in order to determine what children 3 months and younger can be discharged home. The most commonly used protocols include the Rochester, Philadelphia, and now Step-by-Step. Although there is an exceptional comparison of these protocols (Step by Step not included) from Hui et al in 2012, the most important

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Varicella & Pregnancy

Treatment in pregnancy: Chicken Pox Infection Immunized or Hx of past infection: exposure: nothing to do. simple rash: acyclovir 800mg PO 5x/day for 7 days severe infection or pneumonia, admit for IV acyclovir and supportive care. Not Immunized: exposure: consider VZIG, give first dose within 96 hours if possible, and up to 10 days from exposure. simple rash: acyclovir 800mg

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Lyme Disease

Treatment:  PO – for rash, cranial nerve palsy, carditis, or arthritis Doxycycline 100mg PO BID x 14 days Amoxicillin  500mg PO TID x 14 days (use if pregnant) Cefuroxime 500mg PO BID x 14 days IV – for meningitis Ceftriaxone 2gm qD x 14 days Cefotaxime 2gm TID x 14 days Cause: Borrelia burgdorferi spirochete in the USA Borrelia afzelli,

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