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Each year, millions of nonimmigrants visit the United States. Nonimmigrants are defined by the Department of Homeland Security as foreign nationals granted temporary admission into the United States for a [...]

One injection of ceftriaxone appears to be equally effective in treating children with severe ear infections as a 10-day oral treatment with trimethoprim-sulfamethoxazole (TMP-SMZ). Four hundred eighty-four children with severe ear infections were given either a single injection of ceftriaxone or TMP-SMZ for 10 days. Three days after the beginning of treatment 95.1% of the children taking TMP-SMZ and 92.5% of those receiving a ceftriaxone injection were cured. Evaluations done two and four weeks after beginning treatment resulted in smaller but similar cure rates in the two groups., Objective. The purpose of this prospective, randomized, single-blind trial was to assess the clinical efficacy of a single intramuscular dose of ceftriaxone compared with 10 days of oral trimethoprim-sulfamethoxazole (TMP-SMZ) in treating acute otitis media (AOM). Methods. Children aged 3 months through 3 years diagnosed with AOM (signs of acute illness plus evidence of middle-ear effusion) were randomized to treatment with either a single intramuscular dose of ceftriaxone (maximum dose of 50 mg/kg) or 10 days of oral trimethoprim-sulfamethoxazole (8 mg of TMP and 40 mg of SMZ/kg/day in two divided doses). Children were evaluated at scheduled visits on days 3, 14, and 28, and the parents were telephoned on day 5. Children were assessed as cured, improved, or failed on day 3, and as cured or failed on days 14 and 28. Children ill at other times during the study period were, if possible, seen and assessed by the study team. Results. Of 596 children enrolled during the study period, 484 were evaluable. Characteristics of evaluable subjects did not differ significantly by drug. On day 3, 223/241 children in the ceftriaxone group (92.5%) and 231/243 (95.1%) in the TMP-SMZ group were cured or improved. On day 14, 158/197 (80.2%) in the ceftriaxone group and 174/212 (82.1%) in the TMP-SMZ group were cured. On day 28, 108/136 (79.4%) in the ceftriaxone group and 124/155 (80%) in the TMP-SMZ group were cured. Persistence of middle-ear fluid did not differ between groups at day 14 (55% in the ceftriaxone group vs 47% in the TMP-SMZ group; P = .16) or at day 28 (39% vs 43%; P = .48). Pain at the injection site persisting at day 3 occurred in 8.4% of children receiving ceftriaxone. New diarrhea was more common in the ceftriaxone group (23.6% vs 9.2%; P [is less than] .001). Conclusion. A single intramuscular dose of ceftriaxone is comparable in clinical efficacy to 10 days of oral TMP-SMZ for treatment of AOM. Pediatrics 1997;99:23-28; acute otitis media, ceftriaxone, short-course therapy., ABBREVIATIONS. TMP-SMZ, trimethoprim-sulfamethoxazole; AOM, acute otitis media; TM, tympanic membrane; MEF, middle-ear fluid. Otitis media is the most common reason, other than well-child visits, for children to be seen by [...]

It may be premature to recommend influenza vaccination for all children but those at high risk of contracting influenza may benefit. Although there already are effective influenza vaccines, studies have shown that few children are vaccinated. A 1998 study found that a live attenuated influenza vaccine was 93% effective in a group of children. The vaccine was administered intranasally, which would eliminate the need for multiple injections. However, studies have shown that vaccination of high-risk adults is the most cost-effective use of influenza vaccine.