Is Standard Practice 'Standard' In Community Pediatrics?

Abstract

Sir .—After reading the editorial by Fulginiti 1 and the articles by Schunk et al 2 and Caravati et al 3 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