Pediatrics

Flu: Treat Early, Late and Often? Thanks, CDC.

by Dr. Weijen Chang MD FAAP, SFHM Recently, Dr. Tom Frieden, Director of the CDC, in response to criticism about the reduced efficacy of this season’s influenza vaccination has been prominently advocating use of antiviral medications (oseltamivir and zanamivir) for the treatment of influenza infections in adults and children. In short, his philosophy can be paraphrased as, “Treat early, treat late, treat often.” This treatment recommendation, however, seems to be swimming upstream against a growing river of evidence that questions the efficacy of influenza antiviral medications, especially in light of its unfavorable adverse effect profile.  The current CDC recommendations advocate treatment with antivirals for all children hospitalized with influenza infection, despite recent studies showing lack of efficacy in otherwise healthy children.  Considering my concerns as a pediatric hospitalist with the recommendations and the lack of evidence, I decided to touch base with two other pediatric hospitalists Matthew Garber, MD and…

Show Me the Data!

by Weijen Chang, MD, FAAP, SFHM Last August, I sat in a packed ballroom at PHM 2013 in New Orleans, enjoying a raucous yet edifying romp through the highlights of a year’s worth of literature at Top Articles in Pediatric Hospital Medicine.  Barrett Fromme and Ben Bauer wove together education and entertainment while tackling what often can be not much more than a dry list of journal abstracts. Less than a week later, I was honored and horrified to be asked if I would join Barrett in presenting the Top Articles talk at Hospital Medicine 2014. But after the initial shock and fear wore off, the business of planning and preparing a talk began to mitigate my fears of measuring up to Ben Bauer’s comedic timing (and dancing).  Speaking with Barrett, I was impressed by the relative lack of systematic efficiency utilized in refining their list of articles.  While a…