Hospital pediatrics最新文献

{"title":"Pediatric Hospital Medicine FTEs and Staffing Models.","authors":"Lara Batey, Marie Dawlett, Allison Markowsky","doi":"10.1542/hpeds.2026-009408","DOIUrl":"https://doi.org/10.1542/hpeds.2026-009408","url":null,"abstract":"<p><p>Appropriate physician staffing is essential to providing safe, high-quality care for hospitalized children. Many challenges exist in achieving optimal staffing, including financial constraints, coverage of off-hour shifts, recruitment shortages, and building models that promote staff satisfaction and retention. Pediatric hospital medicine (PHM) program leadership must consider the structural needs of their program while building flexibility in their systems to create balanced and sustainable staffing models. With an evolving PHM landscape, these models will likely need to be adjusted over time. Detailed outlines of PHM staffing models, including full-time equivalent definitions, criteria for determining staffing needs, and data on the range of practice environments within the field, are limited in the current literature. Adding such detailed descriptions would be valuable to establish regional and national benchmarks.</p>","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Prediction With Time-Varying Predictors in Pediatric Hospital Medicine.","authors":"Alastair Fung, Joseph Beyene, David D'Arienzo, Rishi P Mediratta","doi":"10.1542/hpeds.2026-009395","DOIUrl":"https://doi.org/10.1542/hpeds.2026-009395","url":null,"abstract":"<p><p>Clinical prediction models traditionally rely on measurements obtained at a single time point to estimate risk and guide management. However, the clinical status of hospitalized children often evolves during admission, and time-varying measurements obtained over the course of hospitalization may provide more accurate, dynamic estimates of risk that better reflect clinical trajectories. Time-varying prediction models are therefore an increasingly important methodological opportunity for pediatric hospitalists seeking to leverage patient-specific longitudinal data in clinical practice. In this article, we review the development of clinical prediction models using time-varying predictors in pediatric hospital medicine, including appropriate clinical settings and data recording, data structuring, analytic approaches, and advantages and limitations. We illustrate these principles using a published example of a time-varying model developed to predict in-hospital mortality among severely malnourished children, highlighting how incorporating daily clinical signs improved predictive accuracy compared with a single time point model using admission data alone.</p>","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy and Disparities in Pediatric Emergency Triage: A Multicenter Retrospective Cohort Study.","authors":"Warren D Frankenberger, Camille P Carter, Cody S Olsen, Huong D Meeks, Joseph J Zorc","doi":"10.1542/hpeds.2026-009554","DOIUrl":"10.1542/hpeds.2026-009554","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the accuracy of the Emergency Severity Index (ESI) in correctly stratifying high-risk pediatric patients and predicting resource use across multiple pediatric emergency departments (EDs), and to identify patient and environmental factors associated with triage accuracy.</p><p><strong>Background: </strong>The ESI is widely used for ED triage in the United States, yet its performance in pediatric populations remains suboptimal. Limited multicenter data exist on factors contributing to inaccurate triage in children's hospitals.</p><p><strong>Methods: </strong>We performed a cross-sectional cohort study using the Pediatric Emergency Care Applied Research Network (PECARN) Registry database from 2012 to 2023. The database includes 17 pediatric EDs across the United States. Undertriage was defined as greater than expected resource usage or acuity compared to the ESI level assigned at triage, and overtriage as being assigned an ESI level exceeding actual care provided. We used multivariable analysis to assess associations between triage accuracy and patient demographics and ED visit characteristics.</p><p><strong>Results: </strong>We evaluated 7.3 million visits. Accuracy was 33% overall, with 35% overtriaged and 32% undertriaged. Undertriage was more common among adolescents, non-English speakers, and minoritized populations. Overtriage was associated with newborn age and ED crowding. Patients who presented for complaints associated with standardized treatment protocols had higher accuracy rates.</p><p><strong>Conclusions: </strong>ESI performance in PECARN Registry pediatric EDs was low, with accuracy varying by age, language, race, and ethnicity. Evidence-based guidelines and decision support tools may improve triage accuracy and reduce inequities.</p>","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatricians' Perspectives on Routine Hospital Discharge Follow-Ups: A Qualitative Study.","authors":"Quynh Pham, Natalie Weston, Farya Phillips, Kelsey Fath, Michelle Gallas, Sanyukta Desai, Tara Greendyk, Jennifer Duc, Alice M Lee","doi":"10.1542/hpeds.2025-009063","DOIUrl":"https://doi.org/10.1542/hpeds.2025-009063","url":null,"abstract":"<p><strong>Background: </strong>There is considerable practice variation among pediatric hospitalists in how they recommend hospital discharge follow-up visits for pediatric patients hospitalized with common, self-limiting, acute illnesses. Literature lacks evaluation of the preferences of primary care pediatricians (PCP) for HDFV.</p><p><strong>Objective: </strong>We aimed to explore PCP perspectives on hospital discharge follow-up visits for pediatric patients hospitalized with common, self-limiting, acute illnesses.</p><p><strong>Methods: </strong>We conducted a qualitative study using a semistructured interview guide to interview PCP working within a 30-mile radius of an academic, urban children's hospital, selected through purposive and maximum variation sampling. The analytic approach was informed by a constructivist-interpretivist worldview, and inductive thematic analysis was used to identify themes.</p><p><strong>Results: </strong>Thematic saturation was reached at 12 interviews. Four major themes emerged relating to PCP perspectives on the necessity, benefits, and drawbacks of hospital discharge follow-up visits. Themes include the following: (1) need for follow-up and optimizing follow-up timing, (2) communication and information-sharing gaps during care transitions, (3) patient centered guidance tailored to psychosocial needs and social drivers of health, and (4) unintended consequences and operational challenges of routine follow-up visits.</p><p><strong>Conclusion: </strong>In healthy children hospitalized for common, self-limiting, acute illnesses, PCP characterize the necessity of routine hospital discharge follow-up visits to be tailored to individual family circumstances and scheduled for optimization according to the expected illness course. PCP perspectives were significantly shaped by health care system factors and information access. These findings offer insights for pediatric hospitalists to optimize anticipatory guidance and follow-up planning at hospital discharge.</p>","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety Considerations for Hospitalized Children and Adolescents With Obesity.","authors":"Stephanie P Gilley, Tiera Nell, Anthony A Wang, Liliane Diab, Meifawn Cooley, Emma L Ross, Jaime M Moore, Ihuoma Eneli, Matthew A Haemer","doi":"10.1542/hpeds.2026-009253","DOIUrl":"10.1542/hpeds.2026-009253","url":null,"abstract":"<p><p>Children and adolescents with obesity make up a growing proportion of hospitalized patients. As a result, pediatric hospital providers are increasingly providing care for patients whose weight meaningfully influences safety during admissions. This review provides practical, evidence-informed guidance for the inpatient care of children and adolescents with obesity to prevent harm and optimize healing. Key safety considerations include identifying obesity-related complications and obesity medications that can impact inpatient risk, using tailored laboratory and imaging strategies that account for body habitus, appropriate medication dosing scalars to mitigate risk for toxicity and/or treatment failure, and recognizing heightened risks during sedation. We also discuss increased risk of venous thromboembolism, ensuring appropriately sized hospital equipment, guidance for nonstigmatizing communication, and safety of hospital staff when moving, lifting, or assisting patients. For patients with prior bariatric surgery, we outline early complications, altered pharmacokinetics, approach to nutrition support, and assessment of micronutrient deficiencies, which can occur rapidly. By centering safety, this review equips hospital-based clinicians to deliver individualized, equitable, and effective care to children and adolescents with obesity. Recognizing obesity comorbidities, partnering across interdisciplinary teams, and minimizing weight stigma can improve clinical outcomes and the patient experience for hospitalized children and adolescents with obesity.</p>","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing Rounds Participation for Caregivers Who Prefer a Language Other Than English.","authors":"Josh Kurtz, Megan Ellis, Frederick Chang, Jack Lanza, Praveen Rodrigo, Hannah Dickens, Megan Roman, Jessica Nguyen, Preston Simmons, Jeremy Jones, Sanjay Chainani, Rebecca Tenney-Soeiro, Jessica Hart, Christopher Bonafide, Kristin D Maletsky","doi":"10.1542/hpeds.2025-009143","DOIUrl":"10.1542/hpeds.2025-009143","url":null,"abstract":"<p><strong>Objectives: </strong>For patients admitted to our hospital medicine resident services, we found that caregivers who were present at bedside and who preferred a language other than English (LOE) participated in family-centered rounds (FCRs) 53% of the time compared with 92% for English-preferring caregivers. We conducted a quality-improvement initiative with the aim of improving monthly FCR participation for LOE-preferring caregivers from 53% to 92%, regardless of preferred language.</p><p><strong>Methods: </strong>We identified drivers of the FCR participation disparity and tested interventions in 3 plan-do-study-act (PDSA) cycles, including changing the rounding order (PDSA 1), sending biweekly emails to raise awareness about the disparity (PDSA 2), and scheduling rounding times with interpreters for LOE-preferring caregivers (PDSA 3). Our primary outcome measure was the percentage of LOE-preferring caregivers participating in FCRs, stratified by Spanish and non-Spanish LOEs. Nurse attendance, FCR participation by an English-preferring caregiver, and average rounds duration per patient were balancing measures. Measures were evaluated using statistical process control charts.</p><p><strong>Results: </strong>We analyzed 17 024 rounding encounters occurring from July 3, 2023, to May 30, 2025. Participation of LOE-preferring caregivers in FCRs increased from 53% to 81%. FCR participation improved for Spanish-preferring caregivers from 57% to 87% and for non-Spanish-LOE-preferring caregivers from 46% to 75%. There was no significant change in English-preferring caregiver FCR participation (92%), nurse FCR attendance (70%), or average rounds duration per patient (13 minutes).</p><p><strong>Conclusions: </strong>Raising awareness of disparities in FCR participation and streamlining interpreter scheduling logistics was associated with improvement in FCR participation for LOE-preferring caregivers without adversely affecting English-preferring caregiver participation, rounds duration, or nurse participation.</p>","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight Gain Goals and Factors Associated With Readmission for Faltering Weight in Infants.","authors":"Emily B Manion, Nehal Thakkar, Peggy Fullenkamp Oomens, John Hartley, Krisha Mansukhani, Lucia Mirea, Reina Patel, Sandra Gage, Brittany Wold","doi":"10.1542/hpeds.2025-008902","DOIUrl":"https://doi.org/10.1542/hpeds.2025-008902","url":null,"abstract":"<p><strong>Objective: </strong>Infants hospitalized for faltering weight are a vulnerable population with limited evidence guiding inpatient management and weight gain targets. We examined associations of patient factors and weight gain target attainment with faltering weight-specific readmission and sought to identify an optimal weight gain threshold associated with reduced readmission.</p><p><strong>Methods: </strong>This retrospective study examined infants aged 1 to 12 months admitted to hospital medicine for faltering weight at a quaternary children's hospital from 2018 to 2022. In-hospital average weight gain was classified as meeting or not meeting World Health Organization (WHO) standards and registered dietitian (RD) recommendations. Associations between readmission and weight gain attainment, demographics, chronic conditions, social factors, and feeding status were assessed using Fisher exact tests, Wilcoxon rank-sum tests, and odds ratios (ORs) with 95% CIs. Logistic regression evaluated readmission in relation to percent average daily weight gain above WHO standards.</p><p><strong>Results: </strong>Among 273 infants, 36 (13.2%) were readmitted for faltering weight within 2 years. Preexisting tube feeds on admission were associated with increased readmission (P = .02; OR 5.80; 95% CI, 1.48-22.73). Infants who met RD goals, especially goals that exceeded the WHO standard, had lower readmission (P = .01; OR 0.30; 95% CI, 0.12-0.73). No percent average daily weight gain above the WHO threshold showed predictive ability or reduced readmission.</p><p><strong>Conclusions: </strong>Individualized, expert-guided nutrition strategies improve outcomes for infants with faltering weight when weight gain goals exceed the WHO standard. Larger, multicenter studies are needed to improve generalizability and statistical power to detect smaller effects.</p>","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Systemic Steroid Use in Children Under 2 with Bronchiolitis and BPD.","authors":"Naseem Alammar, Matt Hall, Vishal Kapadia, Jenny Bohorquez, Vineeta Mittal","doi":"10.1542/hpeds.2025-008721","DOIUrl":"https://doi.org/10.1542/hpeds.2025-008721","url":null,"abstract":"<p><strong>Objectives: </strong>No guidelines exist for managing children with bronchopulmonary dysplasia (BPD) hospitalized with acute bronchiolitis. This study evaluated clinical practice and outcomes associated with systemic steroid use in children with BPD and acute bronchiolitis. We hypothesized there would be significant practice variation and improvement in outcomes with steroid use.</p><p><strong>Methods: </strong>A retrospective study was conducted using the PHIS (Pediatric Health Information System) database. Children aged younger than 2 years with BPD hospitalized from 2012 to 2023 were included. Primary outcomes were systemic steroid use, factors associated with use, and temporal trends. Secondary outcomes were length of stay (LOS), readmissions, intensive care unit use, maximum respiratory support, duration on oxygen, and mortality. Systemic steroid use vs no systemic steroid use groups were compared.</p><p><strong>Results: </strong>Of the 1239 children, 35% received systemic steroids. Steroid use varied from 0% to 75% across hospitals. Hospital-level variation was unrelated to case volume (P = .83). Systemic steroid use was significantly associated with older age, home inhaled corticosteroid (ICS), and in-hospital bronchodilator use, but not with gestational age, birth weight, or BPD severity. Systemic steroid use was significantly associated with longer LOS (2.8 vs 2.2 days, P < .001) and more time on oxygen (2.8 vs 2.3 days, P = .008).</p><p><strong>Conclusion: </strong>A total of 35% of hospitalized children with BPD and bronchiolitis received systemic steroids with significant variation in use. Systemic steroid use was associated with older age, home ICS use, longer LOS, and more time on oxygen. Further studies are needed to understand the clinical implications of these associations.</p>","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal Capillary Blood Sampling Procedure: A Scoping Review.","authors":"Janene Douglas, Deanne August, Jacqueline Cunninghame, Natasha Roberts","doi":"10.1542/hpeds.2026-009239","DOIUrl":"https://doi.org/10.1542/hpeds.2026-009239","url":null,"abstract":"<p><strong>Background: </strong>Neonatal capillary blood sampling is common and painful, but procedural elements (eg, warming) appear inconsistent, with the impact on sampling effectiveness and procedural best practice unclear.</p><p><strong>Objective: </strong>To identify existing procedural practices and knowledge gaps to inform best practice for neonatal capillary blood sampling and guide procedural use in future research.</p><p><strong>Methods: </strong>The Joanna Briggs Institute methodology was used, with sources including peer-reviewed articles between 2005 and 2025 from PubMed, CINAHL Complete (EBSCO host), and Cochrane Library, focused on the neonatal population. Screening was completed in Covidence by 2 independent authors (third for conflicts) and extracted into Airtable with results reported descriptively.</p><p><strong>Results: </strong>Of the 2846 articles identified, 73 met criteria, originating predominantly from the European region (n = 36). Most were randomized controlled trials (n = 47), followed by observational studies (n = 9) and expert opinion (n = 6). Primary outcomes reported (n = 63/73) were predominantly pain assessments (n = 46) and blood sample quality (n = 14). Procedural practices were inconsistently reported across articles-eg, decontamination (33/73 [45%]), supportive care (38/73 [52%]), and lancing device type used (40/73 [55%]). Within articles reporting roles (n = 60/73), nurses/midwives were commonly the proceduralist (n = 30 [50%]), followed by a comforter role (n = 14 [23%]), in addition to parents (n = 20 [33%]). Successful procedural characteristics (12/73) were reported as (1) sufficient blood (1 puncture/incision; n = 5), (2) minimal squeezing/free-flowing blood droplets (n = 3), (3) no hemolysis/adequate blood (n = 2), (4) no hemolysis/free-flowing blood (n = 1), and (5) minimal squeezing/procedure time (n = 1).</p><p><strong>Conclusion: </strong>Inconsistent reporting on procedural elements and device use impedes procedural best-practice evolution and should be a priority of future research.</p>","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beta-Lactam Dose Optimization Using Therapeutic Drug Monitoring in Pediatric Patients.","authors":"Veena Venugopalan, Kalen B Manasco, Ahmad Hachem, Hanzhi Gao, Tao Cui, Frances M Saccoccio","doi":"10.1542/hpeds.2025-008993","DOIUrl":"https://doi.org/10.1542/hpeds.2025-008993","url":null,"abstract":"<p><strong>Objective: </strong>Beta-lactam therapeutic drug monitoring (BL-TDM) is underused in pediatric patients where drug exposure is highly variable. This study evaluated the pharmacokinetic/pharmacodynamic (PK/PD) target attainment of BLs in pediatrics.</p><p><strong>Patients and methods: </strong>A retrospective observational cohort study of BL-TDM was conducted from 2016 to 2023 in hospitalized patients aged 18 years and younger receiving ampicillin, aztreonam, cefazolin, cefepime, ceftriaxone, imipenem, meropenem, oxacillin, or piperacillin with available plasma concentrations. Two PK/PD targets were assessed: 100%fT ≥ minimum inhibitory concentration (MIC) and 100% fT ≥ 4 × MIC. Clinical and microbiological success were evaluated as exploratory endpoints in relation to target attainment.</p><p><strong>Results: </strong>Among 142 BL-TDM events (122 patients, 129 hospital encounters), 69% achieved 100% fT ≥ MIC, whereas 41.5% attained 100% fT ≥ 4 × MIC. Median age was 11 years (IQR, 1-17). Ninety-nine hospital encounters (76.7%) included an intensive care unit admission. Cefepime and meropenem were the most common BLs with available concentrations. Ampicillin and meropenem were among the BLs achieving the highest PK/PD target attainment at 88.9% and 71.4% for 100%fT ≥ MIC and 77.8% and 62.9% for 100%fT ≥ 4 × MIC. Dose adjustments were made in 31% of BLs, with either a switch to continuous infusion or an increase in the daily dose being the most frequently implemented. In the exploratory secondary analysis, clinical and microbiological success rates were high regardless of target attainment. A higher estimated glomerular filtration rate within 24 hours of TDM and younger age were independently associated with target non-attainment.</p><p><strong>Conclusions: </strong>Over half of all patients failed to achieve 100%fT ≥ 4 × MIC with standard BL regimens. Furthermore, dosing adjustments made in nearly one-third of cases further emphasizes BL-TDM's role in individualizing pediatric dosing.</p>","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}