A recent meta-analysis in JAMA Pediatrics highlights the effectiveness of antibiotics as an initial treatment option for uncomplicated acute appendicitis in children. While immediate surgery is traditionally seen as the most effective treatment, antibiotics offer a non-surgical approach that allows many children to recover faster and potentially avoid hospitalization.

A study presented at the Infectious Diseases Society of America's annual meeting found that a tapered and pulsed course of vancomycin was not significantly better than a standard course of the drug for patients with a first or second recurrence of Clostridioides difficile infection. The study, reported by Dr. Stuart Johnson of the Hines VA Hospital in Illinois, involved 299 patients, with 58.6% of those on the tapered/pulsed regimen achieving a sustained clinical response, compared with 44.1% of those on the standard regimen.

Avian flu cases are rising in the US, driven by migratory birds, raising concerns about preparedness during a government shutdown. The USDA reports infections in 62 flocks across 17 states, affecting 6.6 million birds, with cases also in dairy cows and cats. Public health officials cite staffing issues at the CDC and USDA as a challenge, and the current administration has cut pandemic preparedness resources.

Stanford University researchers developed open-source machine learning models to predict the likelihood of bacteremia, aiming to optimize the use of blood culture bottles amid a nationwide shortage. The models, ranging from a simple bedside calculator to an advanced large language model-augmented algorithm, outperform traditional prediction rules and can reduce unnecessary cultures, false positives and costs.

A study published in the Journal of the American Medical Association found an AI-based diabetes prevention program was as effective as a human-led virtual program in helping adults with prediabetes maintain an A1C of less than 6.5%. The app program had higher completion rates and was seen as potentially more accessible for people with busy schedules.

Home automatic external defibrillators may help improve survival in cases of shockable cardiac arrest, but they are not currently cost-effective, according to a study in JAMA Internal Medicine. The cost per quality-adjusted life-year was $4.5 million, exceeding the $200,000 threshold for cost-effectiveness. Researchers noted that about 70% of the more than 300,000 out-of-hospital cardiac arrests each year occur at home and less than 10% of people survive to hospital discharge.

The American Heart Association, working with the American Academy of Pediatrics, updated its guidelines for responding to choking emergencies as part of an update to CPR recommendations in the journals Circulation and Pediatrics. The protocol calls for alternating five back blows with five abdominal thrusts for conscious adults and children, while infants should receive five back blows and five chest thrusts using the heel of one hand.

About 25.7 million people in the US have limited English proficiency, which can be a barrier to health care. Clinicians can improve equity by documenting each patient's preferred language and having certified medical interpreters available. Language-concordant care can reduce hospital lengths of stay, complication risk and readmissions, says Cindy Hou, infection control officer at Jefferson Health New Jersey.