Current Practice Patterns Regarding Diagnostic Investigations and Empiric Use of Acyclovir by Canadian Pediatric Emergency Physicians in Febrile Neonates

Abstract

Canadian pediatric emergency physicians are aware of risk factors for neonatal HSV infection and tailor their history and diagnostic investigations toward the diagnosis of HSV infection, but very few empirically administer acyclovir. Examination of future Canadian HSV guidelines for this patient population is warranted.

Herpes Simplex Virus Infection in Infants Undergoing Meningitis Evaluation

“…Nationally, ED providers do not have a standardized approach to the diagnosis and management of HSV infection in febrile infants. 21,22 We observed a wide variation in the rates of HSV testing and empirical treatment across participating institutions which did not correlate with the local HSV frequency. The similarities between included EDs precluded analyses to determine if hospital-level characteristics (eg, urban versus rural hospital location) are associated with testing and treatment trends.…”

Nationwide survey on current management strategies of toddler’s fractures

“…This was a cross-sectional online survey of Canadian physicians who were members of the PERC network, a network of health care professionals, which aims to facilitate multicentre research projects. 9,10 The survey was piloted on 10 physicians from five different centres and then revised. The final version was emailed to 211 physicians between April and June 2015 using a modified Dillman's method, which consisted of an initial email, followed by reminder emails at 1, 3, and 7 weeks.…”

Inconsistent Management of Neonatal Herpes Simplex Virus Infections

“…12 This reflects the lack of national consensus, which has also been underlined in other countries. 13,14 The American Academy of Pediatrics gives some practical guidance on PCR testing, although precise testing and treatment indications are lacking. 3 The Dutch guideline on febrile infants advises to only treat empirically in cases of neurologic symptoms.…”