At-a-Glance
Pediatric oral formulations: Placebo minitablets mixed with soft food are acceptable for many children 9 months to 7 years, with swallowability improving with age and higher soft-food volumes often preferred.¹
Neonatal renal dosing: Standard neonatal antibiotic dosing already accounts for renal maturation. Dose adjustment should reflect true kidney injury rather than age alone.
U.S. immunization policy shift: The CDC has announced a major reduction in universally recommended childhood vaccines, creating immediate clinical and operational challenges for pediatric care teams.²
New & Notable
Minitablets (compressed tablets 2-4 mm in diameter) mixed with soft food show moderate acceptability in young children.
A randomized crossover study evaluated the acceptability (i.e., swallowability and palatability) of placebo-coated minitablets administered with yogurt or apple sauce in children 9 months to 7 years old. Overall acceptability was rated as high or good in just over half of participants. Swallowability was 77% overall and improved with age.¹
Yogurt was preferred by most children, likely because white-coated minitablets were less visually prominent than in apple sauce. Some children required as much as 30 mL of yogurt or applesauce to successfully swallow the minitablet. Caregivers must ensure the full volume is consumed to deliver the complete dose.¹
The findings support minitablets could be a precise alternative to oral liquids, which are prone to measurement error and less favorable excipient profiles.¹ However, this dosage form is not yet widely available for use.
Clinical Pearl
Expected neonatal renal function is already built into standard dosing.
Standard neonatal antibiotic dosing accounts for gestational age, postnatal age, and/or postmenstrual age, reflecting expected renal maturation and therefore drug clearance. In infants, glomerular filtration rate (GFR) should be used as a marker of function, not injury, and is expected to be low through the first 3-5 months of life. Renal dose adjustments should be made only for neonates and infants with clinically proven acute kidney injury and are not intended for baseline immaturity.
The video When (and How) to Renally Dose Adjust Antibiotics in Neonates & Infants reviews how to make this distinction and avoid unnecessary dose reductions that risk under-treating infection.
Pediatric Pulse
CDC announces major overhaul of the childhood immunization schedule.
In January 2026, federal health officials announced a reduction in the number of universally recommended childhood vaccines, shifting several long-standing routine immunizations to high-risk or shared decision-making categories.²
This change creates a sharp divergence between CDC guidance and existing American Academy of Pediatrics recommendations. Pediatric clinicians will need to navigate insurance coverage uncertainty, increased counseling demands, and the potential return of vaccine-preventable diseases as universal recommendations are withdrawn.²
References
Duncan JC, Page R, Clark J, et al. Acceptability of minitablets in soft food: a randomized crossover study in children. Front Pharmacol. 2026;16:1702183. doi:10.3389/fphar.2025.1702183
CIDRAP News. HHS announces unprecedented overhaul of U.S. childhood vaccine schedule. Published 2026. Accessed January 2026. https://www.cidrap.umn.edu/childhood-vaccines/hhs-announces-unprecedented-overhaul-us-childhood-vaccine-schedule
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— Dr. Su