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Risk of Serious Bacterial Infections in Infants With Bronchiolitis—Reply

Nathan Kuppermann, MD, MPH; David E. Bank, MD; Edward A. Walton, MD; Melvin O. Senac, Jr, MD; Ian McCaslin, MD
Arch Pediatr Adolesc Med. 1998;152(8):820. doi:.
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As we stated in the conclusions of the abstract and text of our article, we believe that routine cultures of the blood and urine in young febrile children with bronchiolitis are unnecessary. This conclusion cannot be generalized to patients with lobar pneumonias or chronic medical conditions complicated by bronchiolitis, because these patients were excluded from the study. In addition, we made no definite conclusions about children 2 months of age and younger because we did not have the statistical power to do so. Although none of the 36 patients with febrile bronchiolitis 2 months and younger had positive blood or urine cultures, the one-sided 95% confidence interval of this result (0%-8%) is too wide to adequately address the issue of cultures for this youngest, highest-risk age group. As we suggest in the article, "More data are needed regarding the subset of febrile infants aged 2 months or younger with bronchiolitis."1(p1207)

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