Authors’ conclusions: the efficacy of single probiotic supplements is limited, compared to combined use of probiotics. To achieve optimal effect on premature infant health, combined use of prebiotic and probiotic, especially Lactobacillus or Bifidobacterium, is recommended.
Reviewers’ commentary: this study shows that the use of synbiotics in premature infants seems to be beneficial, especially the combined use of Lactobacillus spp. and Bifidobacterium spp. However, these results should be taken with caution before translating them into clinical practice, as the most appropriate dose and time of treatment and efficacy in the most immature infants cannot yet be cdetermined.
Carvajal Encina F, Aparicio Rodrigo M. Evid Pediatr. 2021;17:29
Authors’ conclusions: infants discharged early after birth were more likely to be admitted within 28 days. The introduction of postnatal minimum length of stay policies was associated with a long-term reduction in neonatal hospital readmission rates.
Reviewers’ commentary: with the current findings, general conclusions about neonatal early discharge should not be drawn as there could be subgroups with different behaviors.
Rivas Fernández MÁ, Pérez-Moneo Agapito B. Evid Pediatr. 2021;17:30
Authors’ conclusions: secondary screening at child healthcare centers for developmental dysplasia of the hips substantially decreased the age at diagnosis in half of the late presentation cases not diagnosed through neonatal screening, and reduced the risk of high-grade dislocation almost to a quarter.
Reviewers’ commentary: although the secondary screening for developmental dysplasia of the hips manages to detect half of the cases of late presentation, with a lower age and degree of dysplasia compared to those detected by symptoms, in this last group it is not clear if the cause is due to false negatives of the screening or to lack of it.
Oltra Benavent M, Cuestas Montañés EJ. Evid Pediatr. 2021;17:31
Authors’ conclusions: there was no statistically significant difference in symptom duration or severity in children with uncomplicated respiratory infections who received delayed antibiotic prescription compared to immediate or no antibiotic prescription.
Reviewers’ commentary: the delayed prescription makes it possible to reduce the use of antibiotics, it does not increase the risks if the information and the follow-up is adequate and it reduces the associated side effects, which reinforces the need to have enough time for each consultation for a good evaluation of the patient.
Pérez González E, Aizpurua Galdeano P. Evid Pediatr. 2021;17:32
Authors’ conclusions: metformin associated with lifestyle interventions may have a small favorable effect on BMI z-score and insulin resistance. It shows an acceptable safety profile in children and adolescents with obesity. The quality of the available evidence is variable.
Reviewers’ commentary: obesity drug therapy could help to achieve targets in the short and medium term, but the effect in the long term remains unknown. Metformin has a modest effect on BMI and produces frequent gastrointestinal adverse events that could reduce completion of treatments. Individual use of metformin could be proposed in specific obesity cases, especially if they present metabolic consequences.
Esparza Olcina MJ, Fernández Rodríguez MM. Evid Pediatr. 2021;17:33
Authors’ conclusions: enteral zinc supplementation in preterm infants may moderately decrease mortality and probably improve weight gain and linear growth in the short term, but may have little or no effect on the common morbidities of prematurity. There are no data to assess the effect of zinc supplementation on long-term neurodevelopment.
Reviewers’ commentary: zinc supplementation in preterm infants could be beneficial in reducing all-cause mortality and in short-term growth and weight curves, but the evidence is scarce. RCTs with adequate design and power would be necessary to recommend their use routinely.
Ortega Páez E, Flores Villar S. Evid Pediatr. 2021;17:34
Authors’ conclusions: odds of mortality in confirmed pediatric BSI are nearly 3-fold higher for patients receiving a discordant early empiric antibiotic regimen. The impact of improved concordance of early empiric treatment on mortality, particularly in critically ill patients, needs further evaluation.
Reviewers’ commentary: this multicenter study confirms the importance of a correct choice of antibiotic regimen in the first 2 days, while the antibiogram arrives, for children with proven sepsis.
Rodríguez-Salinas Pérez E, Cuestas Montañés EJ. Evid Pediatr. 2021;17:35
Editorial
