The AAP updates its childhood UTI guideline, and family-based treatment added to primary care cut BMI further

The edition in brief

The American Academy of Pediatrics published a GRADE-based guideline on urinary tract infection in children aged 8 days to 5 years with low medical complexity, updating the 2011 version with 8 key action statements (2 strong, 6 conditional, all low or very low certainty) and 4 good practice statements, plus three technical reports. One of these pooled 90 studies and found renal and bladder ultrasound detected vesicoureteral reflux after a first UTI with only 50% sensitivity and 71% specificity. In the TEAM UP trial, 730 children aged 6 to 15 with obesity in 41 US primary care practices were randomised to enhanced standard care with or without family-based behavioural treatment; the combination reduced percent median BMI by 6.4 units against 2.6 (difference −3.8). In a target trial emulation of 742 admissions of children with medical complexity and non-severe pneumonia, starting broad-spectrum antibiotics did not shorten stay or reduce progression compared with aminopenicillins. In 2,771 boys from the ECHO cohort, neonatal circumcision was not associated with autism (OR 0.83, 0.59 to 1.17). TEAM UP is randomised; the pneumonia and circumcision studies are observational.