Pediatrics

Many infants with sickle cell disease miss timely first antibiotic prophylaxis

This cohort compared timing of first antibiotic prophylaxis prescriptions in children with sickle cell disease born between 2008 and 2022. The focus was whether children received prophylaxis by 3 months of age, as recommended to prevent early invasive infection. By directly examining first-prescription timing, the study assesses whether uptake gaps stem from initial prescribing delays versus later nonadherence. Findings highlight a system‑level opportunity to standardize early prophylaxis ordering in newborn and early infant care pathways. 1

Cerebral oximetry–guided care offers no 2‑year advantage in extremely preterm infants

In SafeBoosC‑III, extremely preterm infants were randomized to 72 hours of cerebral oximetry–guided care vs usual care. At 2 years’ corrected age, death or moderate/severe neurodevelopmental disability rates were similar between groups. Bayley cognitive composite scores were virtually identical with and without oximetry guidance. These results suggest routine early cerebral oximetry does not improve major neurodevelopmental outcomes and should not be adopted solely for this purpose. 2

Adolescent opioid harms rose despite major reductions in ED prescribing

This population cohort analyzed 1.2 million ED discharges for adolescents in Alberta between 2010 and 2020. ED opioid prescribing declined from 3.3% of visits to 1.2%, driven by reductions in codeine and oxycodone use. Despite this, opioid-related ED visits, hospitalizations, or opioid agonist therapy within 1 year nearly doubled. General EDs prescribed opioids more often and reduced prescribing more slowly than pediatric EDs. The authors note that broad ED deprescribing alone may not curb opioid harms, especially in youth with complex psychosocial risk factors. 3

Family-based telehealth outperforms individual therapy for weight gain in pediatric ARFID

This randomized trial compared telehealth family-based treatment for ARFID with individual Psychoeducational Motivational Therapy in 98 underweight children aged 6 to 12 years. Family-based treatment produced greater improvement in percent estimated body weight at end of treatment than individual therapy. Overall ARFID symptom severity improved similarly between groups, but more severely affected children benefited more from family-based treatment. These findings support involving families directly and early when targeting weight restoration in low‑weight children with ARFID. 4