The 2026 AAP guideline expands UTI guidance to medically noncomplex children from 8 days through 5 years and uses GRADE methodology. It suggests antibiotic courses of 7 days or less for most children, with age- and syndrome-specific durations, and recommends oral rather than hospitalization-requiring parenteral or sequential therapy for children older than 28 days and younger than 5 years who tolerate oral treatment and do not otherwise require admission. It also updates post-UTI imaging, including renal/bladder ultrasonography after a first febrile UTI and a suggestion against routine VCUG when ultrasonography is normal.
American Academy of Pediatrics / PediatricsOnline Sep 28, 2026
VASSPR was a pragmatic, open-label, cluster-randomized cluster-crossover strategy trial across 13 US hospitals involving 3,959 adults receiving vasopressors for septic shock. Hospitals alternated between recommending fixed-dose vasopressin 0.03 U/min when other vasopressors reached 0.1 versus 0.4 micrograms/kg/min norepinephrine-equivalent. Twenty-eight-day mortality was 31.8% versus 33.0% (adjusted marginal OR 0.98, 95% CI 0.87-1.06; adjusted risk difference -0.4 percentage points, 95% CI -2.7 to 1.3), with no difference in kidney replacement therapy-free days.