Outpatient Treatment of Febrile Children with Sickle Cell Disease

To the Editor: The study by Wilimas et al. (Aug. 12 issue)¹ was well designed and addressed an important clinical problem. I cannot, however, agree with the authors' conclusion that intravenous ceftriaxone has been proved to be an appropriate treatment for selected febrile children with sickle cell disease. Since none of the randomized patients had sepsis, the investigators proved that outpatient ceftriaxone is an effective treatment for children without sepsis. In view of the apparent ability of the selection criteria to distinguish children with sepsis from other patients, it may be concluded that the optimal outpatient treatment for children at…