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2021 Red Book: Definitive source on pediatric infectious diseases in its 32nd edition

May 1, 2021

The Red Book: 2021 Report of the Committee on Infectious Diseases is the first edition in the manual’s 80-year history to be produced during a global pandemic of this magnitude. It continues to be your best resource for managing common and obscure infections as well as preparing your office, hospital or clinic to prevent infectious disease outbreaks.

Now in its 32nd edition, the Red Book has been the definitive source for the diagnosis, treatment and prevention of pediatric infectious diseases since 1938. More than 500 contributors from pediatrics, family practice, obstetrics and gynecology, the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration provided key content, ensuring that this is the most comprehensive Red Book ever. The breadth of knowledge that these world experts bring and the efficient manner in which the material is presented in the print format make this a unique product for busy pediatricians and pediatric subspecialists.

Every one of the 242 chapters has been revised since the 2018 edition, including an overhaul of the coronavirus chapter. Two chapters have been added, one an extensive systems-based treatment table and the other a chapter on Pseudomonas.

Tables, figures and diagrams have been developed to ensure you can access information rapidly to manage your patients. These and other changes are summarized over 14 pages at the beginning of the new edition.

Among the more important changes is a new way to retrieve information using the systems-based treatment table. The chapters in Section 3 continue to be pathogen-specific. So if you know that the organism causing an infection is group B strep, for example, you can go to the GBS chapter to determine the optimal management.

But when first seeing a patient, you know what body system is involved (e.g., urinary tract, central nervous system or bone and joint) but do not yet know the organism causing the infection. The new systems-based treatment table in Section 4 allows you to quickly identify the differential diagnosis of most likely pathogens, the optimal empiric antibiotic(s) to use and the usual treatment duration. Once the organism is identified on culture, you can refer to the pathogen-specific chapters in Section 3 for additional management.

The Red Book also includes immunization-related updates.

  • There are new resources and information on vaccine ingredients and the new hexavalent vaccine.
  • Meningococcal vaccine recommendations now include the new MenACWY vaccine, MenQuadfi.
  • A new figure shows which influenza vaccines are indicated for which age groups, and live attenuated influenza vaccine contraindications have been expanded (e.g., in patients who have had cochlear implants).
  • A new figure simplifies decision-making for administration of the hepatitis B birth dose by birth weight and maternal HBsAg status.
  • Recommendations have been added on when to count Tdap vs. DTaP doses by age (especially in 7- to 10-year-olds).

Other changes

  • The table of disease- or condition-specific recommendations for exclusion of children from group child care has been updated.
  • All chapters relating to sexually transmitted infections have been harmonized with the 2021 CDC guidelines that are in the final stages of development.
  • Hepatitis C treatment options extend down to 3 years of age.
  • New figures summarize HIV newborn testing and prophylaxis recommendations.
  • New measles postexposure prophylaxis tables have been added.
  • The Lyme and Babesiosis chapters have been harmonized with new guidelines from the Infectious Diseases Society of America.
  • The differential diagnosis for and management of recurrent pinworm infection have been included as has a ranking of treatment options for molluscum.
  • Risk assessment approaches for group B strep disease in neonates have been added.
  • The lice treatment table has been updated with new products and over-the-counter indications.

An old African proverb states that if you want to go fast, go alone, but if you want to go far, go together. The Red Book’s impact is due to the hundreds of people who contributed to it. These individuals go far together to improve the lives of children in the U.S. and around the world. It is the hope that these efforts will contribute to the work you do every day to keep children healthy.

Dr. Kimberlin is editor of the 2021Red Book.

Red Book dedicated to Dr. Cooper

The 2021 Red Book is dedicated to Louis Z. Cooper, M.D., FAAP — a giant in the field of pediatrics and pediatric infectious diseases.

At the outset of his career, Dr. Cooper helped lead the world out of the rubella pandemic in the 1960s. Then as AAP president in 2001-’02, he led the Academy through the uncertain times that followed the Sept. 11 terrorist attacks.

Dr. Cooper died in October 2019 of pancreatic cancer and was selected as the recipient of the Red Book dedication prior to the onset of the COVID-19 pandemic. We can think of no one whose legacy can better inform our path forward.

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