WHO Broadens Guidance for Recommended Contraceptives
New WHO guidelines released on September 23, 2026, expand contraceptive choice. They address mifepristone for emergency contraception, extended or continuous combined oral contraceptive (COC) use, extended use of the etonogestrel implant, and two pills not previously included in WHO guidance. COCs can now be taken in extended cycles of up to 6 months or continuously for up to 1 year. Mifepristone is a new emergency contraception option, effective within 5 days of unprotected sex. The goal is to close the gap for an estimated 164 million women with an unmet need for contraception.
Urgent Care implications: Reassure patients that it is safe to skip the placebo week of COCs and start the next pack immediately. Offer emergency contraception up to 5 days after unprotected sex, although mifepristone is not FDA-approved for this use in the US.
Full access: WHO
Patient Experiences of Disrespectful or Judgmental Language in Medical Records
This nationally weighted survey of 500 US adults linked disrespectful or judgmental language (DJL) to markedly lower trust in clinicians to document care accurately and respectfully. Among patient portal users, 17.1% reported DJL in their own or a loved one’s records. Diminished trust was reported by 39.6% of those exposed vs. 13.0% of those not exposed, and the association held after adjustment. Younger adults, people with lower incomes, and those with chronic pain were more likely to report DJL. The authors conclude that open notes must be paired with reform toward respectful documentation.
Urgent Care implications: Many Urgent Care notes are read first by patients through the portal and then by the next clinician. Pain and substance-use visits carry the highest risk of stigmatizing wording. Use neutral, person-first language and describe behaviors and barriers rather than labeling patients.
Full access: JAMA Network Open
Antibiotic Choice for Community-Acquired Pneumonia in Children With Medical Complexity
No guidelines address antibiotic choice for community-acquired pneumonia (CAP) in children with medical complexity, such as those with neurologic impairment, genetic disorders, or congenital heart disease. This retrospective cohort study at an academic children’s health system compared initial ampicillin or amoxicillin with broad-spectrum antibiotics in children hospitalized with nonsevere CAP. Outcomes were similar: time to discharge did not differ, and 90% of the narrow-spectrum group vs. 85% of the broad-spectrum group were discharged by day 10. Progression to severe CAP and 30-day revisits were also comparable.
Urgent Care implications: For a well-appearing, medically complex child with nonsevere CAP, start with amoxicillin rather than reflexively escalating to broad-spectrum agents.
Full access: Pediatrics (AAP)
Hand, Foot, and Mouth Disease: Red Flags You Should Know
Hand, foot, and mouth disease (HFMD) mostly affects children under 5 and presents with fever, sore throat, and a papulovesicular rash on the hands, feet, and mouth, and sometimes on the buttocks or genitals. It resolves in about a week, but painful oral lesions can cause dehydration. Rarely, enterovirus causes brainstem encephalitis, which can progress to autonomic instability and cardiopulmonary failure. Viral shedding in stool and respiratory secretions can continue for weeks after recovery.
Urgent Care implications: Assess hydration, treat pain with ibuprofen or acetaminophen, and recommend cold or soft foods. Give return precautions for prolonged fever, vomiting, lethargy, ataxia, or trouble breathing. Children can return to school when afebrile and not drooling excessively.
Full access: Contemporary Pediatrics