Tag Archives: Antimicrobial Stewardship

Children’s Sinusitis Guideline in Iambic Pentameter

The American Academy of Pediatrics acute sinusitis guideline was too complex for limerickification, and even resisted sonnet format, so here it is in iambic pentameter.

Nasal discharge’s mostly allergic or viral

And thus needs only symptomatic care

With no need for an antimicrobial trial

Unless high-risk and flu virus is there.


Only think sinusitis as a cause

In three scenarios based on the patient’s tale

Note none involve a mucus color clause

So green snot counts not–neither dark nor pale.


First, symptoms exceed 10 days and don’t improve

Or second, improve but then thereafter worsen

(‘Tho this usually means that in has moved

A second virus attacking the same poor person).


Third is when the onset is severe

With fever 39 degrees or higher

And nasal discharge purulent not clear

Both unrelenting for three days required.


For children meeting persistent criteria

Consider observing three days more

And, weighing risks such as diarrhea,

Start antibiotics only if symptoms endure.





Otitis Media Guideline Limerick

Based on good feedback about yesterday’s limerick summarizing the American Academy of Pediatrics (AAP) 2015 Bronchiolitis Guideline, here is one synopsizing the AAP’s 2013 Otitis Media Clinical Practice Guideline:

For those 6-months or older with malaise

And a bulging TM that’s ablaze,

Give analgesia well-dosed

And only antibiose

If not improving in 2-3 days.63df9f26db5aeadee08a296942a1e644

The Antibiotic Apocalypse


I am hopeful that these ominous wake-up calls here and here from the BBC  will lead to policy change, especially related to policies that permit widespread use of antibiotics in livestock feed.  Consumers Union posted a policy summary here and the Center for Disease Control’s website gives a more in-depth look here.