XXXV Summary of Major Changes in the 2018 Red Book MAJOR CHANGES: GENERAL 1. All chapters in the last edition of the Red Book were assessed for relevance in the dy- namic environment that is the practice of pediatric medicine today. This assessment led to the elimination of 27 chapters from the 2018 Red Book. At the same time, 3 chapters were added (Chikungunya, Coagulase-Negative Staphylococcal Infections, and Zika). This results in a 9% overall decrease in the number of chapters in the 2018 Red Book compared with the last edition. 2. Every chapter in the 2018 Red Book has been modified since the last edition. The listing below outlines the more major changes throughout the 2018 edition. 3. To ensure that the information presented in the Red Book is based on the most accu- rate and up-to-date scientific data, the primary reviewers of each Red Book chapter were selected for their specific academic expertise in each particular area. In this edition of the Red Book, 24% of the primary reviewers were new for their assigned chapters. This ensures that the Red Book content is viewed with fresh eyes with each publication cycle. 4. All Diagnostic Tests portions of the pathogen-specific chapters in Section 3 were reviewed by 2 microbiology laboratory experts to ensure that they include state-of- the-art diagnostic modalities. 5. Throughout the Red Book, the number of Web sites where additional current and future information can be obtained has been updated. All Web sites are in bold type for ease of reference, and all have been verified for accuracy and accessibility. 6. Reference to evidence-based policy recommendations from the American Academy of Pediatrics (AAP), the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC), and other select profes- sional organizations have been updated throughout the Red Book. 7. Standardized approaches to disease prevention through immunizations, antimicrobial prophylaxis, and infection-control practices have been updated throughout the Red Book. 8. Recommendations for the use of doxycycline have been liberalized. Recent comparative data in younger children suggest that doxycycline is not likely to cause visible teeth staining or enamel hypoplasia in children younger than 8 years. These reassuring data support the revised recommendation of the AAP that doxycycline can be administered for short durations (ie, 21 days or less) without regard to the patient’s age. When used, patients should be careful to avoid excess sun exposure because of the photosensitivity associated with doxycycline (see Tetracyclines, p 905). 9. Mebendazole is available again in the United States beginning in 2016, after being unavailable for a number of years. It has been added back into the relevant chapters as a therapeutic option.
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