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Is Standard Practice 'Standard' In Community Pediatrics?

E. NOEL PRESTON, MD
Am J Dis Child. 1990;144(1):12-13. doi:10.1001/archpedi.1990.02150250013004.
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Sir.—After reading the editorial by Fulginiti1 and the articles by Schunk et al2 and Caravati et al3 in the May issue of AJDC regarding pediatric coin ingestion, I telephoned 11 fellow pediatricians to learn how they would respond to an asymptomatic child who had swallowed a coin. I also decided to ask whether they would prescribe oral antibiotic therapy or administer an injection of benzathine penicillin to a nonallergic child weighing more than 18 kg whose throat culture results or rapid-strept test results were positive for streptococcal infection.

Atlanta, Ga, is a medical school city with two tertiary care–level children's hospitals that strongly encourage continuing medical education for their physicians. All the pediatricians I questioned are members of the "active" staffs of at least one of the children's hospitals. My questions were the same to each pediatrician: "If you have a totally asymptomatic child in no

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