Authors´ conclusions: among children 5 to 15 years of age who were living in an area with high coverage and use of bed nets, ivermectin, administered once a month for 3 consecutive months, resulted in a 26% lower incidence of malaria infection than albendazole. No safety concerns were identified.
Reviewers´ commentary: the BOHEMIA trial shows that mass administration of ivermectin reduces malaria incidence by 26% (NNT = 4.3 over 6 months), with an acceptable safety profile and programmatic potential as a complementary tool against insecticide resistance. Although methodological limitations warrant caution, the evidence supports its consideration within integrated strategies, with further research needed on effectiveness under real-world conditions and in vulnerable populations.
Authors ́ conclusions: active treatment of hemodynamically significant ductus arteriosus in premature infants during the first two weeks of life was associated with increased morbidity and mortality.
Reviewers ́ commentary: the results of the meta-analysis show an increase in mortality among treated patients which, although modest, is clinically relevant. Routine early pharmacological treatment should be avoided in all preterm infants with patent ductus arteriosus, and an expectant management strategy should be preferred, except in cases with clear signs of hemodynamic compromise. Further research is needed on precise echocardiographic criteria, specific subgroups that may benefit, and more selective interventions.
Carvajal Encina F, Blanco Rodríguez C. Evid Pediatr. 2026;22:12
Authors´ conclusions: based on routine clinical practice data, no increased risk of neuropsychiatric events has been found in children and adolescents treated with montelukast.
Reviewers´ commentary: the study follows an appropriate methodology, providing safety data for treatment with montelukast; however, not enough to stop the surveillance against these possible events.
Moreno Sánchez A, Albi Rodríguez MS. Evid Pediatr. 2026;22:13
Authors´ conclusions: compared to the use of pulmonary surfactant alone, the combination of budesonide and pulmonary surfactant may prevent bronchopulmonary dysplasia in preterm infants, and does not increase the occurrence of related complications
Reviewers´ commentary: administration of budesonide alongside pulmonary surfactant seems to decrease the risk of bronchopulmonary dysplasia, but the magnitude of this effect can be uncertain and there is a lack of information, specially about long-term effects, to be able to recommend it systematically.
Gámez Belmonte A, Aparicio Rodrigo M. Evid Pediatr. 2026;22:14
Authors’ conclusions: there is a great uncertainty around the gender affirming hormone therapy and further studies with rigorous methodology are needed.
Reviewers’ commentary: gender affirmation therapy cannot be accepted or rejected with the results this systematic review provides, since the evidence of the included studies is low or very low.
Gámez Belmonte A, Rivero Martín MJ. Evid Pediatr. 2026;22:15
Authors’ conclusions: among infants with congenital cytomegalovirus infection and normal hearing at birth, the risk of late‑onset sensorineural hearing loss was 6.5%. Ventriculomegaly, white‑matter abnormalities and splenomegaly at birth were associated with increased risk.
Reviewers’ commentary: this large multicenter cohort identifies neonatal clinical and neuroimaging predictors of late‑onset hearing loss in congenital cytomegalovirus infection. Despite limitations inherent to retrospective analyses, the study provides clinically relevant information for risk stratification and audiological follow‑up.
Authors’ conclusions: the optimal doses of intranasal midazolam for procedural sedation in children undergoing laceration repair were 0.4 and 0.5 mg/kg. This finding can inform clinical practice and future studies of intranasal midazolam for procedural sedation.
Reviewers’ comment: overall, the findings support the preferential use of 0.4–0.5 mg/kg for the repair of simple lacerations and may contribute to the standardization of clinical practice. However, their implementation should be approached cautiously in settings with limited technical resources or more heterogeneous populations. The available data do not allow for an adequate assessment of safety regarding rare adverse events.
Rivero Martín MJ, Aparicio Sánchez JL. Evid Pediatr. 2026;22:17
Authors´ conclusions: early use of antibiotics is associated with later childhood asthma and infections, although causal relationship is difficult to prove.
Reviewers´ commentary: the findings of this study strengthen the body of evidence concerning the potential medium-term adverse consequences of early antibiotic exposure. Nevertheless, the immediate therapeutic benefits in the prevention and management of severe conditions remain indisputable.
Author’s conclusions: safety incidents in pediatric emergency departments are frequent and preventable. Variability between centers suggests the influence of structural factors specific to each institution; therefore, it is necessary to implement tailored strategies that promote a proactive safety culture and effective risk management.
Reviewers´ commentary: the methodological limitations of the study partially affect its results. However, errors in medical care in pediatric emergency services are frequent and possibly inherent to our profession. The data provided on frequency, harm, and preventability of those incidents, together with the identification of organizational and communication factors as the main causes, indicate where improvement efforts should be directed.
Suárez Cabezas S, Llerena Santa Cruz E. Evid Pediatr. 2026;22:19
