Diagnosing Urinary Tract Infection in Young Febrile Children in the Emergency Department
This study externally validated UTICalc version 3.0, a race‑neutral clinical prediction tool to estimate the probability of urinary tract infection (UTI) in febrile children 2–24 months old presenting to the emergency department. At a 5% UTI risk threshold, the combined clinical + dipstick model had high sensitivity (~94%) and specificity (~87%), outperforming specificity of clinician prediction (~57%). The tool demonstrated positive net benefit across a range of thresholds, supporting its use as an objective adjunct to clinician judgment in guiding decisions about urine testing and antibiotic initiation. Clinical implications: UTICalc can help reduce unnecessary urine cultures and antibiotic overuse while maintaining high sensitivity for true UTIs, improving diagnostic efficiency and care pathways for young febrile children in emergency settings. Full Access: JAMA
WHO Releases New Target Product Profiles for Urgently Needed Antibiotics
The World Health Organization has released three new Target Product Profiles (TPPs) to guide the development of urgently needed antibiotics for severe drug-resistant infections, focusing on multidrug-resistant gram-negative infections, resistant gram-positive infections in immunosuppressed or critically ill patients, and drug-resistant bacterial meningitis. These TPPs outline minimum and preferred characteristics—including efficacy, safety, pharmacokinetics, access, and affordability—to align researchers, developers, regulators, and funders with pressing clinical needs. Clinical implications: They support better treatment strategies, inform antibiotic stewardship, and could improve outcomes for patients with critical drug-resistant infections. Full Access: WHO
Targeted Multidomain Treatment for Mild Traumatic Brain Injury. A Randomized Clinical Trial
A randomized clinical trial in 162 adults with mild traumatic brain injury (mTBI) compared a targeted multidomain (T‑MD) intervention to usual care. Overall symptom severity and global recovery did not differ significantly between groups, though T‑MD showed greater improvements in specific domains, including vestibular, ocular, and cognitive processing symptoms. These findings suggest that while broad programs may not change overall outcomes, targeted, domain‑specific rehabilitation can address persistent mTBI deficits. Clinical implications: This supports focusing treatment on individual symptom profiles rather than a one-size-fits-all approach. Full Access: JAMA
Mailed Audit and Feedback for Antibiotic Prescribing in Primary Care
A mailed audit-and-feedback (A&F) program for primary care physicians modestly reduced antibiotic prescribing and costs among older adults in Ontario. The intervention showed a high probability of net savings, with an estimated $8.82 returned per dollar spent, and benefits were robust when scaled broadly. Clinical implications: This low-cost, scalable strategy can improve prescribing practices, reduce unnecessary antibiotic use, and lower the risk of antibiotic-associated harms. Full Access: JAMA