{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:55:17Z","timestamp":1787068517946,"version":"build-2736575974"},"reference-count":51,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1997,3,1]]},"abstract":"<jats:p>Objective.\u2003To determine whether oral antibiotics prevent meningitis and serious bacterial infections in children with Streptococcus pneumoniae occult bacteremia.<\/jats:p>\n                  <jats:p>Data Sources.\u2003Using the Medline database, the English-language literature was searched for all publications concerning bacteremia, fever, or S pneumoniae from 1966 to April 1996.<\/jats:p>\n                  <jats:p>Study Selection.\u2003All studies that included a series of children with S pneumoniae occult bacteremia containing orally treated and untreated groups. Children were excluded from individual studies if they were immunocompromised, had a serious bacterial infection, underwent a lumbar puncture, or received parenteral antibiotics.<\/jats:p>\n                  <jats:p>Data Extraction.\u2003Three authors independently reviewed each article to determine the number of eligible children and the outcome of children meeting entry criteria.<\/jats:p>\n                  <jats:p>Data Synthesis.\u2003Eleven of 21 studies were excluded, leaving 10 evaluable studies with 656 total cases of S pneumoniae occult bacteremia identified. Patients who received oral antibiotics had fewer serious bacterial infections than untreated patients (3.3% vs 9.7%; pooled odds ratio, 0.35; 95% confidence interval, 0.17 to 0.73). Meningitis developed in 3 (0.8%) of 399 children in the oral antibiotic group and 7 (2.7%) of 257 untreated children (pooled odds ratio, 0.51; 95% confidence interval, 0.12 to 2.09).<\/jats:p>\n                  <jats:p>Conclusion.\u2003Although oral antibiotics modestly decreased the risk of serious bacterial infections in children with S pneumoniae occult bacteremia, there was insufficient evidence to conclude that oral antibiotics prevent meningitis. Published recommendations that oral antibiotics be administered to prevent serious bacterial infections in children with possible S pneumoniae occult bacteremia should be reevaluated in light of the lower risk of sequelae from S pneumoniae occult bacteremia and newer data concerning side effects from treatment.<\/jats:p>","DOI":"10.1542\/peds.99.3.438","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T19:40:17Z","timestamp":1092426017000},"page":"438-444","source":"Crossref","is-referenced-by-count":49,"title":["Do Oral Antibiotics Prevent Meningitis and Serious Bacterial Infections in Children With\n                    <i>Streptococcus pneumoniae<\/i>\n                    Occult Bacteremia? A Meta-analysis"],"prefix":"10.1542","volume":"99","author":[{"given":"Steven G.","family":"Rothrock","sequence":"first","affiliation":[{"name":"From the Department of Emergency Medicine, Orlando Regional Medical Center;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marvin B.","family":"Harper","sequence":"additional","affiliation":[{"name":"Divisions of Emergency Medicine and Infectious Disease, Boston Children's Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M","family":"Green","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, California."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark C.","family":"Clark","sequence":"additional","affiliation":[{"name":"From the Department of Emergency Medicine, Orlando Regional Medical Center;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Bachur","sequence":"additional","affiliation":[{"name":"Divisions of Emergency Medicine and Infectious Disease, Boston Children's Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel P.","family":"McIlmail","sequence":"additional","affiliation":[{"name":"From the Department of Emergency Medicine, Orlando Regional Medical Center;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip A.","family":"Giordano","sequence":"additional","affiliation":[{"name":"From the Department of Emergency Medicine, Orlando Regional Medical Center;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay L.","family":"Falk","sequence":"additional","affiliation":[{"name":"From the Department of Emergency Medicine, Orlando Regional Medical 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