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The Informed Parent

Scanning the Journals: Antibiotics; Air Guns; Delayed School Entry

by John H. Samson, M.D., F.A.A.P.
Published on Jan. 01, 2000

Otitis Media-related Antibiotic Prescribing Patterns, Outcomes, and Expenditures
PEDIATRICS, Vol. 100 No. 4 October 1997, p.585

This article debunks the concept that more expensive is better. It shows "the more expensive antibiotics were not associated with better out comes 'in new episodes of acute otitis media.'"

As a first line antibiotic for acute ear infections, the less expensive caused better healing than the ones vastly more expensive. It was interesting to note that pediatricians prescribed the more effective and less expensive antibiotic more frequently than family physicians.

It would seem this is a good time to use the common antibiotic more frequently and hold the newer, more costly ones for more complex, resistant or chronic cases.

Serious and Fatal Air Gun Injuries: More Than Meets the Eye
PEDIATRICS, Vol. 100 No. 4 October 1997, p.609

It is interesting how humans can develop items that can cause serious injury without realizing it. A firearm is obviously not something to be played with. An air gun, on the other hand, is frequently "played" with by older children and teenagers. Their parents did not see it as a weapon but more like a toy!

These researchers studied 101 children admitted to a hospital with air gun injuries. The median age of the patient was 10.9 years and 81% were boys. 34% of the injuries occurred at home. 36% occurred at the home of a friend or relative. 71% of the shootings were completely unintentional; only 5% were assaults and 1% a suicide. 49 out of the 101 patients had head injuries; 56% of the 101 cases required surgery.

Three of the ten children with brain injuries died and two more had long-term neurologic deficite. 38 children had eye injuries leaving 15 of them permanently blind.

I'm not advocating banning air guns but it is a parental obligation to be sure that their children are properly counseled and trained in the use of them. Use the same precautions with air guns as you do with regular firearms and your children will be a lot safer. In other words, use common sense.

Increased Behavior Problems Associated With Delayed School Entry and Delayed School Progress
PEDIATRICS, Vol. 100, No. 4 October 1997, p. 654

Here's a shocker! In my practice many parents delay school entry so the child will be older, more mature and in some cases physically bigger, therefore, better in sports. Many of these children were ready for school but were nevertheless held in preschool for one more year.

This paper indicates that the popular trend of delaying school entry may ultimately prove harmful to the child.

To quote the author, "Conclusions. Whereas grade retention is associated with increased rates of behavior problems in children and adolescents, simply being older than others in one's class, without having experienced grade retention, is also associated with increased rates of behavior problems, most noticeably among adolescents. These data suggest that there may be latent adverse behavioral outcomes that result from delaying children's school entry."

It wouldn't be the first time that well-meaning parents and educational advisors started a movement based on thought without research, only to find out that when the research was in, the advice was not in the best interest of the child. We must not jump to conclusions. But this paper must cause parents to reassess the concept that starting school a year later is always in the best interest of the child.

Take the time to read the article and decide for yourselves. The decisions you make for your children can be very far reaching.

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