Rosemarie Boland

Follow-up of children born very preterm: the need for evidence-based frameworks to drive best practice and standardised care. This viewpoint discusses the national guidelines for follow-up of growth, health and development of children born very preterm (<32 weeks’ gestation) developed by the Australian Centre of Research Excellence in Newborn Medicine in 2022. Learn more here: bit.ly/4er4bld

Incidence of herpes simplex infection among febrile infants under 3 months of age: evidence from two multisite cohorts. In 3733 febrile infants ≤90 days presenting to UK EDs, HSV infection was rare: 0.2% (95% CI 0.0 to 0.8) in those <29 days and none in older infants. This supports current consensus that well-appearing infants aged 29–90 days do not require routine empiric HSV testing or treatment unless specific risk factors are present. However, many neonates with HSV disease, including disseminated infection, present afebrile with non-specific signs of sepsis; therefore, the 0.2% estimate likely underestimates the true incidence. UK Paediatric Antimicrobial Stewardship guidelines recommend aciclovir for neonates with suspected sepsis and any of the following: ALT/AST>2× the upper limit of normal, coagulopathy, vesicular rash, seizures, CSF pleocytosis, suspected meningitis or encephalitis, recent maternal HSV infection or postnatal HSV contact. Aciclovir is also advised for neonates aged 3–14 days with sepsis who have no clear cause, are not improving, or where there is unexplained maternal febrile illness. Read more about the findings here: bit.ly/3QCWUVu