Oral amoxicillin holds up against injectables in chest-indrawing pneumonia

The edition in brief

Today's paediatrics edition leads with a meta-analysis of seven randomised trials in children aged 2 to 59 months. For fast-breathing pneumonia, oral amoxicillin reduced treatment failure at day 14 against no antibiotic (relative risk 0.84, 95% CI 0.75–0.94, I² 0%, moderate certainty). For chest-indrawing pneumonia without danger signs, outpatient oral amoxicillin matched inpatient injectable antibiotics on treatment failure and was associated with lower mortality (RR 0.28, 95% CI 0.09–0.86), though the absolute risk difference was small. The American Academy of Pediatrics has published a clinical report on congenital cytomegalovirus recommending hearing-targeted plus expanded testing, with key action statements on diagnosis, initial evaluation and treatment of both cCMV disease and isolated sensorineural hearing loss. A cross-sectional appraisal of 14 hospital paediatric sepsis guidelines from 13 countries rated all of them low methodological quality, with concordance against Surviving Sepsis Campaign 2020 ranging from 42% to 100% and the widest variation in steroid indications (43% consistency). Preliminary findings from the BICYCLE study of 205 four-year-olds born in England's first lockdown found caregiver-reported executive function well below both norms and the children's own non-verbal reasoning. The edition closes on an Ontario population screening programme in which only two of 347 infants examined had cCMV-attributable eye findings, and none of those with asymptomatic infection did.