Archives De Pediatrie最新文献

{"title":"Endobronchial foreign body in children: can it be predictable?","authors":"Corentin Stavart ,&nbsp;Eddy Bodart","doi":"10.1016/j.arcped.2026.01.003","DOIUrl":"10.1016/j.arcped.2026.01.003","url":null,"abstract":"<div><h3>Background</h3><div>Foreign body aspiration (FBA) is a critical paediatric emergency that requires prompt recognition and management to avoid severe complications. Diagnosis is challenging due to variable clinical presentations, requiring a combination of history, physical examination, and imaging. Rigid bronchoscopy remains the gold standard for diagnosis and treatment but is associated with a significant proportion of negative procedures.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, single-centre review of paediatric bronchoscopies for suspected FBA over 30 years at CHU UCL Namur, Godinne, Belgium. Clinical, radiological, and procedural data were analysed, including symptomatology, foreign body characteristics, and follow-up outcomes.</div></div><div><h3>Results</h3><div>Among 99 bronchoscopies performed for suspected FBA, a foreign body was confirmed in 58 cases (59%). The highest incidence occurred in children aged 1-3 years (69%). Penetration syndrome was a strong predictor (sensitivity: 90%, Odds ratio (OR): 26.9; 95% CI:8.9-81.2, negative predictive value (NPV): 0.84). Asymmetric auscultation was the most discriminative clinical sign of FBA (specificity: 98%, OR: 42.9; 95% CI: 5.5-332.9, positive predictive value (PPV): 0.97). Unilateral hyperinflation was the most specific radiological sign (specificity: 88%, OR: 16.0; 95% CI: 5.4-47.5, PPV: 0.89). Organic foreign bodies, mainly nuts (74%), were the most common. Rigid bronchoscopy was used in 36% of cases, flexible in 37%, and both in the remaining cases. Complications occurred in 48% per-procedurally and 35% post-procedurally, but no fatalities were reported. Complete clinical recovery was achieved at 6-month follow-up.</div></div><div><h3>Conclusion</h3><div>Diagnosis of FBA relies on clinical examination, detailed medical history, and radiological findings, with both rigid and flexible bronchoscopy remaining essential for diagnosis and management.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"33 2","pages":"Article 105477"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Which one is the most effective on the hand functions in hemiparetic cerebral palsy: constraint-induced movement therapy or constraint-induced movement therapy with virtual reality? A randomized controlled trial","authors":"Cetin Sayaca ,&nbsp;Esin Kadıkoylu ,&nbsp;Eren Demırayak ,&nbsp;Ozden Ozkal ,&nbsp;Filiz Eyuboglu ,&nbsp;Mahmut Calık ,&nbsp;Defne Kaya-Utlu","doi":"10.1016/j.arcped.2025.12.002","DOIUrl":"10.1016/j.arcped.2025.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Motor control of the upper limb is very important for play, personal care, and daily living activities. Losing the motor function of the hand limits the daily life activities, educational, and social participation of children with cerebral palsy (CP).</div></div><div><h3>Objective</h3><div>To compare the effects of constraint-induced movement therapy (CIMT) with virtual reality (CIMT+VR) use, only CIMT use, and traditional therapy (TT) on hand functions in children with hemiparetic Cerebral Palsy (h-CP).</div></div><div><h3>Material and Methods</h3><div>Children who were h-CP would be divided into three groups randomly (TT (tradit, CIMT, CIMT+VR groups). Hand function and performance were evaluated with the Jebsen-Taylor and Moberg pick-up tests.</div></div><div><h3>Results</h3><div>Forty-five children participated in the present study. There were no differences in sex, affected side, age, hand function, or performance between groups. After six weeks of therapy, a difference in hand function was observed between groups. However, there were no differences in the functional performance of the hemiparetic hand after therapy.</div></div><div><h3>Conclusion</h3><div>Using CIMT and VR together improved hand functions, while there was no change in the functional performance of the hand.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"33 2","pages":"Article 105469"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential hidden dangers in household products for infant’s immune system: Consequences for childcare","authors":"Christophe Dupont ,&nbsp;Sandra Brancato ,&nbsp;Rosan Meyer ,&nbsp;Martin Chalumeau ,&nbsp;Dominique Darmaun ,&nbsp;Marie Laure Frelut ,&nbsp;Dominique Guimbert ,&nbsp;Alexandre Lapillonne ,&nbsp;Arnaud de Luca ,&nbsp;Sophie Nicklaus ,&nbsp;Noel Peretti ,&nbsp;Jean-Pierre Chouraqui ,&nbsp;Comité de Nutrition de la Société Française de Pédiatrie (CN-SFP)","doi":"10.1016/j.arcped.2025.09.006","DOIUrl":"10.1016/j.arcped.2025.09.006","url":null,"abstract":"<div><h3>Background</h3><div>The increase in allergic, autoimmune, and metabolic diseases observed in recent decades correlates with increased exposure to new chemicals that can damage the epithelial barrier, regardless of its location, the skin, respiratory, and digestive tract. Infants are often exposed to detergents and disinfectants from birth.</div></div><div><h3>Objectives, methods, and setting</h3><div>Published data indicate a potentially harmful impact of these chemicals on the epithelial barrier, which could promote allergies. The aim of this article is to review the available data on how these chemicals affect the epithelial barrier.</div></div><div><h3>Results</h3><div>We depict the likely harmful role of common household products in the development of allergies in children.</div></div><div><h3>Conclusion</h3><div>We suggest simple changes in everyday life aimed at reducing contact with these products in infants and young children.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"33 2","pages":"Article 105449"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bubble-CPAP in low-resource countries: Review of the literature and proposed protocol for use in children with pneumonia and bronchiolitis in Senegal","authors":"Amadou Sow ,&nbsp;Aliou Thiongane ,&nbsp;Papa Moctar Faye ,&nbsp;Djibril Boiro ,&nbsp;Younoussa Keita ,&nbsp;Aliou A Ndongo ,&nbsp;Amadou Lamine fall ,&nbsp;Francois N. Diouf ,&nbsp;Malick Ndiaye ,&nbsp;Assane Sylla ,&nbsp;Ousmane Ndiaye ,&nbsp;Mohammod Jobayer Chisti ,&nbsp;Marti Pons-Òdena ,&nbsp;Guillaume Emeriaud","doi":"10.1016/j.arcped.2025.09.005","DOIUrl":"10.1016/j.arcped.2025.09.005","url":null,"abstract":"<div><h3>Objective</h3><div>The main objective of this study is to develop a protocol for the safe use of b-CPAP in children under five years with severe pneumonia or bronchiolitis in Senegal, based on evidence from a review of the literature.</div></div><div><h3>Methods</h3><div>We conducted a literature review on the use of b-CPAP in pneumonia and bronchiolitis in resource-limited countries. We included only randomized studies and meta-analyses in children under five years of age with pneumonia or bronchiolitis.</div></div><div><h3>Results</h3><div>Out of a total of 27 studies identified in our search, we included four randomized trials, including a total of 2181 patients. The age of patients was 28 days-59 months in three studies, and less than 12 months in one study. Overall, the use of b-CPAP was associated with improvements in clinical outcomes: reduced mortality, fewer signs of respiratory distress, and shorter hospitalization lengths, except for one study that identified a worse outcome when b-CPAP was used without medical supervision. Based on these data, we have developed a management protocol that we plan to test and roll out in Senegal.</div></div><div><h3>Conclusion</h3><div>We propose an evidence-based protocol that should be feasible, safe, and applicable in remote regions of Senegal. However, its effectiveness should be monitored and evaluated based on the clinical outcomes observed after implantation.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"33 2","pages":"Article 105448"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interleukin-36 receptor antagonist deficiency patient with a novel mutation","authors":"Müge Sezer ,&nbsp;Fatma Aydın ,&nbsp;Eda Özaydın ,&nbsp;Elif Çelikel ,&nbsp;Ahu Yorulmaz ,&nbsp;Resul Karakuş ,&nbsp;Banu Acar","doi":"10.1016/j.arcped.2025.12.005","DOIUrl":"10.1016/j.arcped.2025.12.005","url":null,"abstract":"<div><h3>Background</h3><div>The deficiency of interleukin-36 receptor antagonist (DITRA) is a monogenic autoinflammatory condition associated with generalized pustular psoriasis (GPP). Diagnostic criteria and treatment recommendations for DITRA are inadequate. The diagnosis is established by detecting a biallelic loss-of-function mutation in <em>IL36RN,</em> which leads to activation of the IL36 pathway.</div></div><div><h3>Observation and discussion</h3><div>We present a pediatric case of GPP with a novel <em>IL36RN</em> mutation that supports the diagnosis of DITRA. In patients with DITRA unresponsive to IL-1 targeted therapies, favorable results may be achieved with the administration of TNF-α inhibitors, particularly IL-36 pathway inhibitors. Twenty-nine papers, encompassing 55 pediatric cases, were synthesized to contextualize treatment responses.</div></div><div><h3>Conclusion</h3><div>Novel DITRA-associated mutations continue to be discovered. Given the rarity of the disease, it will be possible to reveal the genotype-phenotype relationship in the future with the publication of larger DITRA case series.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"33 2","pages":"Article 105472"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective descriptive and analytical study of trends in the clinical and allergenic profiles of atopic children in a Mediterranean Country (1992–2022)","authors":"Hela Cherif,&nbsp;Ghada Berkaoui,&nbsp;Ferdaous Yangui,&nbsp;Salma Mokaddem,&nbsp;Mohamed Ridha Charfi","doi":"10.1016/j.arcped.2025.10.005","DOIUrl":"10.1016/j.arcped.2025.10.005","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric allergic diseases are a growing global public health concern due to their increasing prevalence and impact on children’s quality of life. In Tunisia, the incidence of these conditions has risen markedly, with evolving clinical and allergenic patterns over time.</div></div><div><h3>Aims</h3><div>This study aims to describe the epidemiological evolution of clinical and allergenic profiles in atopic children in Tunisia over a 30-year period.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of children aged 1–16 years who were referred for allergic manifestations to the allergy clinic of the Internal Security Forces Hospital (FSI), La Marsa, and underwent skin prick testing (SPT) between 1992 and 2022. Trends were compared across three decades (D1:1992–2001, D2: 2002–2011, and D3:2012–2022) for the entire cohort and within three age groups (preschool, school-aged, and adolescents.</div></div><div><h3>Results</h3><div>A total of 4313 children were included (mean age: 7.7 ± 3.5 years; sex ratio: 1.39). A family history of atopy was reported in 58.9 % of cases. Rhinitis (76.4 %) and asthma (63.9 %) were the most common presentations. Multiple allergic manifestations were more frequent than isolated ones (58.8 % <em>vs.</em> 41.1 %). SPTs were positive in 57.4 % of cases; dust mites were the most frequent allergen (66.6 %), followed by animal dander and pollens. Polysensitization was observed in 49.7 % of children, most frequently involving dust mites in combination with other allergens. Over the three decades, there was a marked increase in the prevalence of multiple allergic manifestations (from 51.4 % in D1 to 68.5 % in D3; <em>p</em> &lt; 0.001) and polysensitization among sensitized children (from 35.5 % in D1 to 61.1 % in D3; <em>p</em> &lt; 0.001). The age-stratified analysis revealed that this trend towards complexity begins in early childhood, with the rate of polysensitization in preschoolers (1–5 years) soaring from 27.0 % to 62.0 % (<em>p</em> &lt; 0.001). In adolescents (≥12 years), asthma prevalence remained stable (<em>p</em> = 0.124), while rhinitis, rhinoconjunctivitis, and polysensitization continued to increase significantly.</div></div><div><h3>Conclusion</h3><div>This study highlights significant changes towards greater frequency and complexity of pediatric allergic diseases over the past 30 years, characterized by a rise in multiple manifestations and polysensitization. These trends, particularly pronounced in preschoolers, suggest an accelerated allergic march, warranting adapted clinical and public health strategies.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"33 2","pages":"Article 105456"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tacrolimus in pediatric patients with Henoch-Schönlein purpura nephritis: Target concentration range","authors":"Fashuang Li,&nbsp;Huiying Li,&nbsp;Linbo Li,&nbsp;Lilin Zhang","doi":"10.1016/j.arcped.2025.09.002","DOIUrl":"10.1016/j.arcped.2025.09.002","url":null,"abstract":"<div><h3>Objective</h3><div>This study seeks to establish the therapeutic reference range for tacrolimus blood concentrations in pediatric patients diagnosed with Henoch-Schönlein purpura nephritis (HSPN) and to evaluate the factors influencing tacrolimus pharmacokinetics in this population.</div></div><div><h3>Methods</h3><div>Receiver operating characteristic (ROC) curve analysis was utilized to determine the optimal therapeutic threshold for tacrolimus concentration. Comparative analyses were conducted to assess clinical efficacy and adverse event profiles across four groups of tacrolimus concentrations [Group A(&lt;3 ng·mL^-1), Group B (3-&lt;5 ng·mL^-1), Group C (5-&lt;10 ng·mL^-1), and Group D (≥10 ng·mL^-1)], thereby establishing a reference therapeutic range. Kaplan-Meier survival analysis was employed to evaluate differences in continuous remission survival rate and remission duration among four distinct concentration groups, validating the precision of the target trough concentration range. Additionally, multivariate linear regression analysis was performed to identify significant factors influencing tacrolimus concentrations.</div></div><div><h3>Results</h3><div>A cohort of 105 pediatric patients diagnosed with HSPN were enrolled in this study. After six months of tacrolimus therapy, the ROC curve analysis revealed that the tacrolimus trough concentration had significant diagnostic value for clinical efficacy, with an area under the curve (AUC) of 0.816 (<em>P</em> &lt; 0.01), and an optimal cutoff value of 3.02 ng·mL^-1. Comparative analysis of clinical efficacy across four groups demonstrated that Group A exhibited significantly lower efficacy compared to the other groups. After 12 months of tacrolimus treatment, the diagnostic utility of the ROC curve was further confirmed, with an AUC of 0.798 (<em>P</em> &gt; 0.05), indicating limited predictive performance. Although no significant differences in adverse event rates were observed among the four groups, Group D displayed a notably higher incidence of nephrotoxicity relative to the other groups. Multivariate linear regression analysis identified serum creatinine level as a significant determinant of tacrolimus concentration (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>In pediatric patients with HSPN in China, maintaining tacrolimus trough concentrations within the therapeutic range of 3–5 ng·mL^-1 has been demonstrated to achieve optimal therapeutic efficacy.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"33 2","pages":"Article 105444"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrapartum group B streptococcus (GBS) detection by intrapartum PCR versus antenatal culture at 35-38 weeks of gestation: Justification for a crossover, cluster randomized controlled trial, and protocol summary","authors":"Marine Godfroy ,&nbsp;Agnès Caille ,&nbsp;Isabelle Durand Zaleski ,&nbsp;Pauline Scherdel ,&nbsp;Marion Boivin ,&nbsp;Ingrid Benard ,&nbsp;Anne Chauvire-Drouard ,&nbsp;Valery-Pierre Riche ,&nbsp;Vincent Dochez ,&nbsp;Norbert Winer ,&nbsp;Christèle Gras Le Guen","doi":"10.1016/j.arcped.2025.11.003","DOIUrl":"10.1016/j.arcped.2025.11.003","url":null,"abstract":"<div><div>The incidence of neonatal group B streptococcus (GBS) related to early onset sepsis (EOS) has decreased dramatically with antenatal culture screening and intrapartum antibiotic prophylaxis (IAP) implementation during the 1990s. However, while 30 % of women are currently exposed to intrapartum antibiotics, 52 to 82 % of newborns with GBS-EOS were born to mothers with negative antenatal GBS culture screening who did not receive IAP, because of possible intermittent maternal GBS colonization. Intrapartum GBS screening by Polymerase Chain Reaction (PCR) has been suggested as a suitable tool to improve and replace the usual antenatal GBS culture screening between 35 and 38 weeks of amenorrhea for optimizing the IAP indications, but its cost is often cited as an obstacle. Using a cluster crossover randomized controlled trial, we aim i) to conduct a cost-consequence analysis of two screening strategies and ii) to compare newborn and maternal morbi-mortality related to GBS-EOS and antibiotic exposure rate according to an intrapartum screening strategy versus usual antenatal culture screening (DEPIST2P study).</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"33 2","pages":"Article 105467"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accidental cannabis intoxications in toddlers: what to expect? A case report","authors":"Lorena Wagnez,&nbsp;Christelle Loudoux,&nbsp;Clara Pinotti,&nbsp;Hyppolite K. Tchidjou","doi":"10.1016/j.arcped.2025.10.011","DOIUrl":"10.1016/j.arcped.2025.10.011","url":null,"abstract":"<div><h3>Background</h3><div>Although the management of acute intoxications is well codified, managing accidental cannabis poisoning in children remains a challenge.</div></div><div><h3>Observation and discussion</h3><div>Consider a toxic etiology in toddlers means firstly thinking about it, and secondly knowing the main symptoms that can reveal cannabis intoxication in children.</div></div><div><h3>Results and conclusion</h3><div>In this case report, we sought to highlight the importance of good healthcare providers’ management regarding unintentional cannabis exposure in toddlers.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"33 2","pages":"Article 105463"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of implementing repeated clinical audits and feedback on outpatient antibiotic prescribing in the pediatric emergency department of a French university hospital.","authors":"Mariem Ben Yaghlane, Arnaud Florentin, Ouarda Pereira, Anne Borsa-Dorion, Cyril Schweitzer, Alexandre Charmillon","doi":"10.1016/j.arcped.2026.01.002","DOIUrl":"https://doi.org/10.1016/j.arcped.2026.01.002","url":null,"abstract":"<p><strong>Background: </strong>The burden of antimicrobial resistance is a significant public health challenge, especially in young children, driven by antibiotic misuse.</p><p><strong>Objective: </strong>This study aimed to assess the impact of repeated prospective clinical audits, with a systematic feedback design, on enhancing antibiotic prescribing practices among outpatients visiting the Pediatric Emergency Department of a teaching hospital located in the north-eastern region of France.</p><p><strong>Methods and setting: </strong>We conducted a before-and-after study design over 13 months (2021-2023), performing clinical audits to assess antibiotic prescribing practices. The standards were based on guidelines from French scientific societies. We implemented a multimodal improvement plan, including regular meetings with prescribers. After each educational session, we reassessed antibiotic prescription patterns and provided rapid feedback to encourage timely adjustments.</p><p><strong>Results: </strong>Outpatients accounted for 79% of emergency visits. Over 13 months, we retained 1477 prescriptions. The distribution of diseases remained consistent throughout periods. The overall guideline adherence rate was 75% during the preintervention period and remained stable throughout the study. In situations where antibiotics were recommended, this rate was 51.6% at baseline and 50% in the postintervention period. Nonetheless, adherence to treatment initiation guidelines increased significantly, from 88.9% to 96.6%. Furthermore, the proportion of appropriate antibiotic selections increased from 82.2% to 93.2% (p = 0.001). Additional analysis indicated a reduction in antibiotic consumption among pediatric outpatients during the study period.</p><p><strong>Conclusion: </strong>These results show that implementing an antibiotic stewardship program in pediatric emergency departments can improve adherence to antibiotic guidelines. These findings support the need to expand antimicrobial stewardship programs in pediatric settings.</p>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":" ","pages":"105476"},"PeriodicalIF":1.3,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}