Pediatrics – Infectious Diseases
Phase 2 RCT: Preventive subcutaneous L9LS monoclonal antibody reduces malaria incidence by 66-70% in Malian children – N Engl J Med
7 May, 2024 | 15:31h | UTCThis phase 2 randomized clinical trial investigated the safety and efficacy of the monoclonal antibody L9LS in preventing Plasmodium falciparum infection and clinical malaria in children aged 6 to 10 years in Mali. The trial was structured in two parts: initial dose assessment in adults followed by a randomized, placebo-controlled test in children over a 6-month malaria season. A total of 225 children participated, divided equally among three groups to receive either 150 mg of L9LS, 300 mg of L9LS, or a placebo. Results demonstrated a significant reduction in the rate of P. falciparum infection—66% efficacy with the 150-mg dose and 70% efficacy with the 300-mg dose. Similarly, efficacy against clinical malaria was 67% with the 150-mg dose and 77% with the 300-mg dose. Both doses were well-tolerated with no safety concerns reported, underscoring the potential of L9LS as a preventative treatment against malaria in endemic regions.
Reference (link to abstract – $ for full-text):
RCT: No significant benefit of adjuvant prednisone for patients with cystic fibrosis with exacerbations unresponsive to antibiotics – Eur Respir J
6 May, 2024 | 06:32h | UTCThis randomized, double-blind, placebo-controlled trial investigated the effectiveness of adjuvant oral prednisone in enhancing lung function recovery in patients with cystic fibrosis (CF) experiencing pulmonary exacerbations (PExs) unresponsive to initial intravenous (IV) antibiotic treatment. The study involved 173 participants, with 76 not achieving more than 90% of their baseline forced expiratory volume in one second (ppFEV1) by Day 7 of antibiotic treatment and subsequently randomized to receive either oral prednisone (1 mg·kg−1 twice daily, up to 60 mg/day) or placebo for an additional 7 days. Results showed that 50% of the prednisone group and 39% of the placebo group recovered over 90% of their baseline ppFEV1 by Day 14. However, the difference was not statistically significant (11% difference; 95% CI -11, 34%; p=0.34). Additionally, prednisone did not significantly prolong the time to the next exacerbation compared to placebo. This study concludes that adjuvant oral prednisone does not significantly improve lung function recovery or delay subsequent exacerbations in CF patients not responding to initial antibiotic therapy.
Reference (link to abstract – $ for full-text):
RCT: Azithromycin fails to prevent moderate or severe chronic lung disease in preterm infants – Lancet Respir Med
6 May, 2024 | 06:28h | UTCThis randomized, placebo-controlled trial evaluated the effectiveness of azithromycin in preventing chronic lung disease (CLD) in preterm infants born at less than 30 weeks’ gestation across 28 UK neonatal intensive care units. A total of 799 infants were randomized to receive either intravenous azithromycin or a placebo. The primary outcome measured was survival without moderate or severe CLD at 36 weeks postmenstrual age. Results showed no significant difference between the azithromycin group (42% survival without CLD) and the placebo group (45% survival without CLD), with an adjusted odds ratio of 0.84 (95% CI 0.55–1.29, p=0.43). Pulmonary Ureaplasma spp colonization did not affect the treatment outcome. Given the lack of efficacy and the presence of several serious adverse events in the azithromycin group, the study concluded that azithromycin should not be recommended for preventing CLD in this population.
Reference (link to free full-text):
ERS statement on protracted bacterial bronchitis in children
11 Aug, 2023 | 15:32h | UTCERS statement on protracted bacterial bronchitis in children – European Respiratory Journal
Multinational Study | No correlation between Covid-19 and onset of type 1 diabetes in children
8 Aug, 2023 | 13:32h | UTC
A novel comprehensive algorithm for evaluation of pediatric ICU patients with new fever or instability
7 Aug, 2023 | 14:53h | UTC
Practice Guidance | Management of febrile neutropenia in immunocompetent children and youth
3 Aug, 2023 | 13:38h | UTC
Study | Childhood deaths in high-mortality settings mostly preventable; infection, malnutrition top causes
31 Jul, 2023 | 14:05h | UTCInvited Commentary: Need for a Structural Approach to Promote Child Survival – JAMA Network Open
News Release: Eight out of ten child deaths in low-income countries could be prevented – Barcelona Institute for Global Health
RCT | Limited antibiotic efficacy in children with sinusitis lacking nasopharyngeal pathogens
27 Jul, 2023 | 13:08h | UTCIdentifying Children Likely to Benefit From Antibiotics for Acute Sinusitis: A Randomized Clinical Trial – JAMA (free for a limited period)
Editorial: Acute Bacterial Sinusitis: Limitations of Test-Based Treatment – JAMA (free for a limited period)
News Release: Bacterial testing in kids with sinusitis could slash antibiotic use – University of Pittsburgh
Commentary: Trial suggests bacterial test could reduce antibiotics in kids with sinusitis – CIDRAP
Commentary on Twitter
In children with acute sinusitis, antibiotic treatment had minimal benefit for those without nasopharyngeal bacterial pathogens. The antibiotic effect did not depend on the color of nasal discharge. https://t.co/hgRx1Qou53 pic.twitter.com/zYs8Mfbjjp
— JAMA (@JAMA_current) July 26, 2023
Global, regional, and national burden of meningitis and its etiologies, 1990–2019
25 Jul, 2023 | 13:55h | UTC
Commentary on Twitter
Although largely preventable, meningitis still causes hundreds of thousands of deaths globally each year.
New @IHME_UW #GBDStudy in @TheLancetNeuro assesses incident cases and deaths due to acute infectious meningitis by aetiology and age from 1990–2019. https://t.co/S3KtMA7DMs pic.twitter.com/AYuSJHsNwK
— The Lancet (@TheLancet) July 20, 2023
M-A | Exposure to smoke, overcrowding, poor living conditions, and contact with TB cases identified as risk conditions for pediatric TB
24 Jul, 2023 | 12:43h | UTC
Phase 2 Trial | Maternal GBS6 vaccine shows promise in infant group B strep prevention
21 Jul, 2023 | 13:34h | UTCCommentary: Maternal strep B vaccine slashes risk of infection among infants – CIDRAP
Cohort Study| Childhood development delayed by 4.39 months due to COVID-19 pandemic
13 Jul, 2023 | 13:11h | UTCAssociation Between the COVID-19 Pandemic and Early Childhood Development – JAMA Pediatrics
Commentary: Studies describe pandemic’s lasting influence on children – CIDRAP
Global Burden of Disease Study | Understanding global trends of infectious diseases in younger population, 1990-2019
10 Jul, 2023 | 13:54h | UTCNews Release: Global efforts to reduce infectious diseases must extend beyond early childhood – Murdoch Children’s Research Institute
Commentary: Global infectious disease burden shifting from younger to older youth – CIDRAP
RCT | Lower rates of treatment failure with standard-course vs. short-course therapy in pediatric UTIs
5 Jul, 2023 | 01:09h | UTCShort-Course Therapy for Urinary Tract Infections in Children: The SCOUT Randomized Clinical Trial – JAMA Pediatrics (link to abstract – $ for full-text)
See also: Visual Abstract
Commentary: Treatment Failure Down With Standard-Course Therapy in Pediatric UTI – HealthDay
Cluster RCT | Point-of-care CRP testing cuts antibiotic prescriptions in respiratory illnesses in primary care
1 Jun, 2023 | 11:58h | UTCCommentary: Use of CRP testing reduced antibiotics for respiratory infections, trial finds – CIDRAP
Review | Invasive mold infections in children: navigating troubled waters with a broken compass
31 May, 2023 | 14:05h | UTC
M-A | Shorter vs. longer-term antibiotic treatments for community-acquired pneumonia in children
31 May, 2023 | 13:42h | UTCShorter Versus Longer-term Antibiotic Treatments for Community-Acquired Pneumonia in Children: A Meta-analysis – Pediatrics (link to abstract – $ for full-text)
Commentary: Meta-analysis supports shorter antibiotic courses for kids’ pneumonia – CIDRAP
Related:
M-A | Examining shorter antibiotic treatment durations for community acquired pneumonia in adults
SR | Balanced crystalloid solutions versus 0.9% saline for treating acute diarrhea and severe dehydration in children
25 May, 2023 | 11:15h | UTC
RCT | Tonsillectomy shown to be clinically and cost-effective in adults with recurrent acute tonsillitis
23 May, 2023 | 13:06h | UTCSummary: The NATTINA trial, a pragmatic multicentre, open-label, randomized controlled study, sought to compare the clinical and cost-effectiveness of conservative management versus tonsillectomy in adults with recurrent acute tonsillitis. Conducted across 27 UK hospitals, 453 participants aged 16 or older were randomly assigned to either undergo immediate tonsillectomy or receive standard non-surgical care.
The main finding was that participants in the immediate tonsillectomy group had fewer days of sore throat over a 24-month period than those in the conservative management group (median 23 vs. 30 days). After adjusting for site and baseline severity, the incident rate ratio of total sore throat days in the immediate tonsillectomy group was significantly lower than in the conservative management group (0.53, 95% CI 0.43 to 0.65, p < 0.0001). The most common adverse event related to tonsillectomy was bleeding, which occurred in 19% of participants.
The NATTINA trial is the largest to date assessing the clinical and cost-effectiveness of tonsillectomy in adults. The results indicate that immediate tonsillectomy is clinically effective and cost-effective for recurrent acute tonsillitis. However, patients should weigh the benefits of fewer sore throat days against the risks of surgery.
News Release: Tonsillectomy both clinically and cost effective for adults – Newcastle University
Commentary on Twitter
Compared with conservative management, immediate tonsillectomy is clinically effective and cost-effective in adults with recurrent acute #tonsillitis, suggests trial. https://t.co/LvSjn6XUx0 pic.twitter.com/yKzH9RqY5J
— The Lancet (@TheLancet) May 18, 2023
Cohort Study | Long-term risk of epilepsy following invasive Group B Streptococcus disease in neonates
9 May, 2023 | 14:25h | UTC
Podcast | Fungi fun! an in-depth look at tinea infections in children
18 Apr, 2023 | 13:14h | UTCFungi Fun! An In-Depth Look at Tinea Infections – The Cribsiders
Consensus Paper | Best management of patients with an acute sore throat
6 Apr, 2023 | 13:32h | UTC
Updated WHO Guidelines | COVID-19 boosters no longer routinely recommended for low-risk groups
30 Mar, 2023 | 14:33h | UTCSummary: The WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) has revised its COVID-19 vaccination roadmap in light of the Omicron variant and widespread population immunity. The revised roadmap prioritizes protecting those at the highest risk of severe disease and death while maintaining resilient health systems. It introduces cost-effectiveness considerations for vaccinating lower-risk individuals, such as healthy children and adolescents, and presents revised booster dose recommendations.
Priority groups are categorized as high, medium, and low, based on factors like risk of severe disease and death. People in the high-priority group, consisting of older adults, individuals with significant comorbidities or immunocompromising conditions, pregnant persons, and frontline health workers, are advised to receive additional boosters 6 or 12 months after the last dose. The medium priority group, which includes healthy adults without comorbidities and children with comorbidities, is recommended to receive primary series and first booster doses. However, SAGE no longer routinely recommends additional boosters for this group due to limited public health gains.
For the low-priority group, encompassing healthy children and adolescents, vaccination decisions should take into account factors such as disease prevalence and cost-effectiveness. It is important to note that the public health benefits of vaccinating healthy children and adolescents are considerably lower compared to established essential vaccines for children, like rotavirus, measles, and pneumococcal conjugate vaccines.
News Release: SAGE updates COVID-19 vaccination guidance – World Health Organization
Commentaries:
No More COVID-19 Boosters for Healthy People, WHO Experts Recommend – Health Policy Watch
WHO vaccine advisers update COVID vaccine recommendations – CIDRAP
SR | Consequences of Shigella infection in young children
30 Mar, 2023 | 13:52h | UTC