Authors´ conclusions: the strategy of delaying the antibiotic treatment in non-severe acute otitis media in children up to 15 years old reduces its indiscriminate use.
Reviewers´ commentary: the use of delaying antibiotic treatment in non-severe acute otitis media (absence of fever, unilaterality and absence of otorrhea) could be a useful tool to reduce the use of antibiotics, as long as a general criterion for its indication is generated.
Esparza Olcina MJ, Flores Villar S. Evid Pediatr. 2022;18:23
Authors´ conclusions: azithromycin use in children with poorly controlled asthma, along with background inhaled treatment, improves control and decreases exacerbations.
Reviewers´ commentary: the prevalence of uncontrolled asthma is low in children after having verified that the inhalation techniques are correct and the comorbidities corrected. Use of azithromycin in children with long-term uncontrolled asthma may be recommended but studies with larger samples and follow-up are needed.
Ruiz-Canela Cáceres J, Rodríguez-Salinas Pérez E. Evid Pediatr. 2022;18:24
Authors´ conclusions: the use of fluid therapy with higher sodium content is associated with a lower risk of cerebral edema in the treatment of diabetic ketoacidosis.
Reviewers´ commentary: use of isotonic solutions in the rehydration of diabetic ketoacidosis is associated with a reduced risk of cerebral edema. With the information to date available, this practice seems recommendable; although randomized experimental studies are needed to check efficacy and safety.
Balado Insunza MN, Ochoa Sangrador C. Evid Pediatr. 2022;18:25
Authors´ conclusions: the use of inhaled corticosteroids for the treatment of asthma in the first six years of life does not seem to influence bone mineral content at that age, regardless of the cumulative dose administered. On the other hand, the authors have found an association with a smaller height at 6 years, but only in those patients who continue with treatment during the sixth year of life and who have previously had a high accumulated dose of inhaled corticosteroids.
Reviewers´ commentary: maintenance therapy with inhaled corticosteroids up to the age of 6 years could decrease height, more pronounced the reduction the higher the total dose administered. Although, it is not clear whether this decrease in height is transitory or permanent, it seems prudent to closely monitor the prognosis of height.
De Manuel Gómez C, Ortega Páez E. Evid Pediatr. 2022;18:26
Authors´ conclusions: there was no special variation regarding premature birth (<37 weeks) or stillbirth (fetal demise as of 20 weeks of gestational age) rates over the first 12 months of the SARS-CoV-2 pandemic, beyond the natural variation observed over the 17.5 years before the pandemic started.
Reviewers´ commentary: this is a retrospective cohort study run in Ontario (Canada). The statistical techniques employed (control charts, interrupted time series analysis) and its population-based nature make the present study one of the soundest studies on the topic from a methodological point of view. However, its geographic restriction hampers the generalization of the study´s results to other areas where the pandemic or the Health System´s characteristics might have been different.
Zozaya Nieto C, Esparza Olcina MJ. Evid Pediatr. 2022;18:27
Authors´ conclusions: potent and moderate topical corticosteroids are probably more effective than mild topical corticosteroids, primarily in moderate or severe eczema; however, there is uncertain evidence to support any advantage of very potent over potent topical corticosteroids. Effectiveness is similar between once daily and twice daily (or more) frequent use of potent topical corticosteroids to treat eczema flare-ups, and topical corticosteroids weekend (proactive) therapy is probably better than no topical corticosteroids/reactive use to prevent eczema relapse (flare-ups). Adverse events were not well reported and came largely from low- or very low-certainty, short-term trials. In trials that reported abnormal skin thinning, frequency was low overall and increased with increasing potency.
Reviewers´ commentary: moderate or high potency corticosteroids are recommended for the treatment of eczema, preferably once daily and preventively twice a week if the patient has frequent relapses. Very high potency corticosteroids should be avoided because they do not improve clinical efficacy and have more side effects.
Martínez Rubio M.V, Aparicio Rodrigo M. Evid Pediatr. 2022;18:28