| Titre : | Appropriateness of Rabies postexposure prophylaxis treatment for animal exposures. (2000) |
| Auteurs : | G.J. MORAN ; J.E. CHILDS ; W. MOWER ; J.Y. NAKASE ; M. NEWDOW ; S. Ong ; R.W. PINNER ; D.A. TALAN ; Emergency Id Net Study Group. INC ; National Center for Infectious Diseases. Centers for Disease Control and Prevention. Atlanta. GA. USA ; Olive View-University of California. Los Angeles. Medical Center. Sylmar. USA ; University of California. Los Angeles. School of Medicine. Los Angeles. USA |
| Type de document : | Article |
| Dans : | JAMA - Journal of the american medical association (vol. 284, n° 8, 2000) |
| Pagination : | 1001-1007 |
| Langues: | Anglais |
| Mots-clés : | Rage ; Virose ; Infection ; Prévention santé ; Exposition ; Incidence ; Facteur risque ; Homme ; Epidémiologie ; Economie santé |
| Résumé : | [BDSP. Notice produite par INIST eR0x18fg. Diffusion soumise à autorisation]. Context Rabies postexposure prophylaxis (RPEP) treatments and associated costs have increased in the United States. The extent to which RPEP use is consistent with guidelines is not well understood. Objective To characterize animal contacts and determine the frequency and factors associated with inappropriate RPEP use. Design, Setting, and Patients Prospective case series study of patients presenting with an animal exposure-related complaint from July 1996 to September 1998 at 11 university-affiliated, urban emergency departments (the Emergency ID Net). Main Outcome Measures Exposure type, circumstances, and RPEP use (appro-priateness defined by local public health departments). Results Of 2030 exposures, 1635 (81%) were to dogs ; 268 (13%) to cats ; 88 (4%) to rodents/rabbits ; 10 (0.5%) to raccoons ; 5 (0.2%) to bats ; and 24 (1.2%) to other animals. Among those exposed, 136 (6.7%) received RPEP after dog (95), cat (21), raccoon (8), bat (4), or other animal (8) exposures. Use of RPEP varied by site (range, 0% - 27.7% of exposures), with most frequent use reported at sites in the eastern United States. Management was considered appropriate in 1857 exposures (91.5%) Use of RPEP was considered inappropriate in 54 cases (40% of those in which it was given), owing to factors including animal availability for observation and exposure in a low-endemicity area. Rabies postexposure prophylaxis was considered inappropriately withheld from 119 cases (6. (...) |
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