Minerva S. Victoria

The Effect of Intradermal and Subcutaneous Route of Administration on Variation in PPD Sensitivity

From the Department of Pediatrics, State University of New York, Downstate Medical Center and Kings County Hospital Center, Brooklyn, NY. * Fellow in Pediatric Chest Diseases; †Assistant Professor of Pediatrics; ‡Assistant Professor of Pediatrics. Correspondence to M. S. Victoria, M.D., Department of Pediatrics, Kings County Hospital Center, 451 Clarkson Ave., Brooklyn, NY 11203. HE INTRADERMAL MANTOUX TEST is the most accurate and reliable method of tuberculin testing. However, a false negative result may be obtained in spite of infection with t~rl. txcbereiclosis.’~~ One of the many reasons given for obtaining a false , negative reaction has been that the test material was erroneously given subcutaneously. 3.7,8 We here report on a comparative study of the skin reactions obtained from the simul-

683 ANTIBIOTIC USE IN PEDIATRIC PATIENTS IN A CITY HOSPITAL

A four year prospective study (1977-1980) was done at Kings County Hospital, Brooklyn, to assess the impact of education of house officers and attending staff on the appropriateness of antibiotic usage in children on the pediatric medical wards. During the study, in the month of March every year charts were reviewed of children in whom antibiotics were used. In 1977, 30.9% of all admissions had antibiotics used. In these children 46.9% were judged as having antibiotics “not indicated”. An intense educational program for the pediatric staff ensued consisting of lectures, chart audits and visits to the institution by at least two visiting professors in infectious diseases. As the table shows, in 1978 not only was there a significant reduction of antibiotic usage, there also was a significant decrease in the number of children in whom the antibiotics were “not indicated”. Further, this significant improvement continued into 1979 and 1980. The study has been very gratifying in terms of house staff education and also the value of cost effectivity in the use of antibiotics in a city hospital

A Comparative Study of the Old Tuberculin Tine Test and the PPD-Tine Test

Forty-one children suspected of having tuberculosis were simultaneously given an intermediate strength Mantoux test, an old tuberculin tine test (OT), and a purified protein derivative (PPD) tine test. Each test was read at 48 hours, and the largest diameter of induration was recorded. Twenty-nine patients had a positive reaction to the Mantoux test, 20 patients had a positive reaction to the OT tine test, and 16 patients had a positive reaction to the PPD-tine test. There were seven instances of a doubtful reaction to the OT tine test and nine to the PPD-tine test. Two children with positive Mantoux tests had negative OT tine tests, and four with positive Mantoux tests had negative PPD-tine test reactions. There was a significant difference between the number of positive reactors to the Mantoux test and both tine tests. If all tine test reactions of 2 mm or more were considered positive (doubtful plus positive reactors), there was no significant difference between any of the tuber culin tests. All suggestively positive tine reactors should, therefore, be retested with a Mantoux test to avoid false-negative interpretation of the tines.

A Two-Year experience with cromolyn sodium in children with asthma

A two-year experience with cromolyn sodium in children with asthma drawn from inner city population, is presented. Though the initial response to the drug at six weeks was excellent, the response over a two-year period was only very moderate. The possible reasons for this are discussed.

Cromolyn sodium in the treatment of children with asthma

We have reported our experience with cromolyn sodium in the management of fifteen children with chronic, intractable asthma. The overall improvement in 80% of children is in accordance with some of the studies reported in the literature. The most significant effect of the drug was in either reducing the dose of steroid needed for management or eliminating its requirement by the patient.