Paediatrics
Kidney and bladder ultrasound missed half of vesicoureteral reflux after a first childhood UTI
The evidence review behind the new AAP urinary infection guideline finds ultrasound unreliable for reflux; clarithromycin was linked to milder infant pertussis than azithromycin; and missing newborn vitamin K nearly tripled intracranial bleeding odds.
A procalcitonin-based rule cut antibiotics in febrile infants from 38% to 26% with no detected rise in harm
A European cluster trial shows point-of-care procalcitonin and urine testing can spare antibiotics in fever without source with no detected rise in harm; pooled trials question the rule of oral-only rehydration in severe malnutrition; and simple family-centred care eases NICU parents' anxiety.
Egg allergy fell after guidelines moved egg into the first six months
Population data from Melbourne show egg allergy dropping after advice to introduce egg earlier, most in infants with eczema; a second skeletal survey still finds extra fractures in suspected abuse; and a simple prescribing alert kept short antibiotic courses for skin infections going for two years.
Prophylactic dextrose gel did not protect neurodevelopment at school age — and may harm wellbeing
The hPOD follow-up found no cognitive benefit at 6–7 years from a single dose of dextrose gel at birth. Also: clesrovimab through two RSV seasons in high-risk infants, a consensus definition of neonatal encephalopathy, family-focused support in type 1 diabetes, and antifungals in newborns.
Maternal RSV vaccination was about 80% effective against infant RSV hospital admission in real-world use
Seven post-rollout studies from three countries confirm the trial result outside it. Also: medication plus lifestyle gave the largest BMI falls in adolescent obesity, a single-dose PCV13 primary schedule held up to age five while PCV10 did not, and six red flags that pointed to Marfan syndrome in children.
Kawasaki aneurysms tracked with late IVIG, IVIG resistance and age under six months
A 40-year Italian cohort of 533 children found coronary aneurysms, though uncommon, caused every persistent coronary abnormality, and IVIG after day 10 raised the odds five-fold. Also: gaps in paediatric FH care, outcomes of eating-disorder stabilisation admissions, virtual reality before chemotherapy, and dichloroacetate for PDC deficiency.
Half of children with mild head injury still get a CT — six in ten in adult hospitals
A US trauma-registry study finds CT use for mild paediatric head injury barely moved in seven years. Also: autism rates that did not rise when everyone was screened, congenital CMV screening, bespoke milk fortification, and an ibuprofen syringe recall.
Oral amoxicillin holds up against injectables in chest-indrawing pneumonia
Seven trials and 12,563 children settle two long-open questions about WHO pneumonia management, the AAP issues a congenital CMV clinical report recommending hearing-targeted plus expanded screening, and an Ontario screening programme finds almost no eyes worth examining.
Vitamin K refusal is rising, and intracranial bleeding tracks it
Two million Swedish births show what happens when newborn vitamin K is declined; clarithromycin outperformed azithromycin in hospitalised infants with pertussis; and a single night of oximetry misses obstructive sleep apnoea in children with Down syndrome.
The ban on drips in severe malnutrition rests on less evidence than the alternative
Three trials, 484 children: intravenous rehydration in severe acute malnutrition with severe dehydration caused no fluid overload and halved severe hyponatraemia; a procalcitonin-based rule cut antibiotics in febrile infants by a third; and silver diamine fluoride arrests half of active caries lesions.
Two chemotherapy cycles swapped for an antibody, and fewer infections with it
Replacing two cycles of conventional chemotherapy with blinatumomab in high-risk paediatric B-cell leukaemia lifted four-year event-free survival from 70.3% to 83.0% and cut treatment-related infection from 69.4% to 23.9%; structured lactation support raised exclusive mother's milk feeding across fifteen NICUs.
Prophylactic dextrose gel does nothing for school-age cognition and may cost something else, while a single RSV antibody dose covers a whole season
Seven-year follow-up of the hPOD trial finds no cognitive benefit from prophylactic buccal dextrose gel and a signal of worse emotional-behavioural outcomes; clesrovimab matches monthly palivizumab with one dose; a maternal high egg and peanut diet does not prevent infant allergy; and a point-of-care alert held a stewardship gain for two years after the teaching stopped.
Maternal RSV vaccination was about 80% effective against infant RSV admission in real-world use
Seven post-rollout studies confirm RSVpreF in pregnancy protects infants to six months, lifestyle plus medication gave the largest BMI falls in adolescent obesity, and a single-primary-dose PCV13 schedule held up to age five.
Maternal RSV vaccination prevented about four in five infant RSV admissions in its first year in Australia
Real-world effectiveness was highest in the youngest infants. Also: the AAP's updated RSV immunisation policy, why a second skeletal survey still earns its radiation dose, and what parental phone use may do to vocabulary.
Autism occurrence held flat across 12 birth cohorts when every child was screened
A population-wide screening study of more than 62,000 South Korean seven-year-olds found no rise in incidence or prevalence across children born 1998 to 2010. Plus a negative NICU fortification trial, and a quarter of people with seizures in endemic regions have neurocysticercosis.
Oral amoxicillin holds against injectables in chest-indrawing pneumonia, and probiotics made juvenile arthritis no better
Three trials and 4,864 children: outpatient oral amoxicillin matched inpatient injectable antibiotics on treatment failure for chest-indrawing pneumonia without danger signs, with lower mortality. The absolute numbers are small; the programmatic implication is not.
Forty years of Kawasaki disease points at delay, not the drug
Aneurysms were predicted by age under six months, IVIG resistance and treatment after day 10; hospital sepsis guidelines worldwide are methodologically poor but mostly agree on the time-critical steps; and half of children with familial hypercholesterolaemia miss their LDL goal.
Most paediatric sepsis deaths are decided before the PICU, and speech therapy that starts before speech
Phoenix criteria and what they have not fixed, CAR-T explained for the general paediatrician, a pregnancy diet trial with a mixed result, and which delirium tool to actually use.
Earlier egg worked at population scale, and a brush-on treatment arrests caries without a drill
The AAP's 2026-27 COVID-19 vaccine position, two hepatitis A vaccine platforms compared head to head, and the NICU interventions that actually move parental anxiety.
Checking gastric residuals every six hours achieved nothing but fewer calories
A 4700-child trial removes a near-universal PICU ritual, clarithromycin outperforms azithromycin in infant pertussis, and dextrose gel given at birth shows no cognitive benefit at school age.
Maternal RSV vaccine holds up outside the trial, and saline holds its ground in septic shock
Real-world data from three countries put effectiveness against RSV hospitalisation at 78 to 82 per cent in the first six months; a reduced pneumococcal schedule works for the 13-valent vaccine but not the 10-valent; and a 9,041-child trial finds balanced fluid no better than 0.9 per cent saline for kidney outcomes in septic shock.
RSV season rules widen, and the second-season group grows
The AAP's technical report sets out who gets immunised and when for 2026-27. Also: GLP-1 prescribing in eight- to eleven-year-olds up 310-fold but still reaching only the least deprived, a headset that reduces anticipatory nausea before the second cycle, and the case for diagnosing functional neurological disorder on rule-in signs rather than normal scans.
Most children treated for bone and joint infection do not have MRSA
A decade of US data says the hospital-wide antibiogram is the wrong number to base empiric cover on; a NICU lifted first-attempt intubation success from 45% to 61% with video laryngoscopy and nasal high flow; and a Welsh audit defends the second skeletal survey.
Maternal RSV vaccination cut infant hospital admissions by 61%
The UK's national programme, now in steady state, prevented three quarters of RSV admissions in the first three months of life. Plus an 81% reduction in influenza hospitalisation from antivirals started within 48 hours, and one in five schoolchildren turning to AI for emotional support.
Take the admission bloods from the placenta, not the baby
A Cochrane review finds cord blood sampling for admission tests likely reduces treatment-requiring retinopathy of prematurity, the AAP widens second-season RSV immunisation, and five-year data show most children with type 1 SMA on risdiplam are alive and feeding orally.