Narrow-spectrum antibiotics did as well as broad ones for pneumonia in medically complex children

The edition in brief

Children with medical complexity admitted with pneumonia are often started on broad-spectrum antibiotics, and no guideline covers them. A target-trial emulation of 742 admissions with non-severe community-acquired pneumonia found no advantage for broad-spectrum over aminopenicillin treatment in time to discharge (HR 0.84, CI 0.68–1.04), progression to severe pneumonia, or 30-day revisits. The study excluded children with tracheostomies, chronic lung disease, sickle cell disease and immunosuppression. The American Academy of Pediatrics' technical report on its 2026 urinary tract infection guideline for children aged 8 days to 5 years explains a revised definition that requires pyuria in most cases and sets culture thresholds by age and collection method, aiming to cut overdiagnosis without missing infections. An umbrella review of 23 meta-analyses covering 2.8 million children found screen use associated with lower academic achievement and language skills and more internalising and externalising problems. The correlations were small, and causation cannot be inferred. A systematic review of support for parents of excessively crying babies found that education reduced parental stress or anxiety, with low-quality evidence overall. The pearl covers how to talk to parents about a crying baby.