Pediatric hospital medicine continues to evolve as a specialty, fueled by growing recognition of the distinct needs of hospitalized children and an expanding focus on quality, safety, and systems-based care. This growth is mirrored in an increasingly robust body of literature, making regular review critical to advancing clinical practice.
In keeping with tradition, a selection of the top pediatric hospital medicine articles from the past year was presented at SHM Converge 2026 in Nashville, Tenn. The review process involved screening over 17,000 titles and abstracts, with 255 full-text articles further narrowed to approximately 50, which were scored across four domains using a 40-point rubric.
The following review highlights the top articles of 2025, including a meta-analysis on clesrovimab for prevention of RSV disease in healthy infants and nirsevimab against hospitalizations and emergency department visits for lower respiratory tract infection in infants.
Clesrovimab is a monoclonal antibody with an extended half-life that binds to site IV of the RSV fusion protein, allowing single-dose, single-season protection. The phase 3 trial of clesrovimab demonstrated efficacy against RSV-associated, medically attended, lower respiratory infection and efficacy against RSV-associated hospitalization in healthy preterm and full-term infants.
A meta-analysis of 15 real-world studies offers validation of nirsevimab’s real-world effectiveness, showing a reduction in lower respiratory tract infection hospitalizations, a reduction in lower respiratory tract infection emergency department visits, and effectiveness against RSV-specific lower respiratory tract infection emergency department visits.
A prospective observational study analyzed 64,708 children undergoing procedural sedation, including 4,421 with autism spectrum disorder. The study found that children with autism spectrum disorder did not have higher rates of critical adverse events, but did have significantly higher rates of airway complications.
The clinical implication is clear: children with autism spectrum disorder should be sedated in settings equipped for advanced airway management, with personnel trained in pediatric airway rescue and appropriate backup plans in place. They require careful consideration to ensure safe sedation.
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Other notable articles include a systematic review and meta-analysis on infant outcomes, risk factors, and diagnostic yield after a brief resolved unexplained event, as well as a study on the evaluation of influenza vaccine clinical decision support systems bundle for hospitalized children.
A multicenter retrospective cohort study evaluated the association between initial antibiotic route and outcomes for children hospitalized with pneumonia.
A PHIS study using interrupted time series analysis evaluated the real-world impact of the 2022 AAP hyperbilirubinemia guidelines.
Additional studies focused on the derivation and validation of predictive models for early pediatric sepsis, as well as the prediction of bacteremia and bacterial.
These studies demonstrate the ongoing evolution of pediatric hospital medicine, with a focus on improving outcomes and advancing clinical practice through evidence-based research.
Initiatives to improve the discharge process for Spanish-speaking patients, such as providing interpretation services, highlight the importance of addressing healthcare disparities and ensuring that all patients receive high-quality care, regardless of their language proficiency.
