| Tirzepatide reduced HbA1c by 2.23% at 30 weeks in children and adolescents aged 10 to 17 years with type 2 diabetes. In the 10 mg group, 86% achieved HbA1c ≤6.5%.1 |
| Gentamicin should not be relied on for gram-negative coverage when meningitis is suspected because of poor CSF penetration. The preferred cephalosporin differs by age group. |
| A federal court has temporarily blocked revised CDC vaccine recommendations issued over the past year. The ruling restores the pre-January 2026 immunization schedule while litigation continues.2 |
At 30 weeks, 86% of participants receiving tirzepatide 10 mg achieved HbA1c ≤6.5% compared with 28% in the placebo group. Glycemic efficacy was sustained through 52 weeks of treatment. Tirzepatide 10 mg reduced BMI by 11.2% at 30 weeks and 15.1% at 52 weeks compared with 0.4% in the placebo group.1
Gastrointestinal adverse events were the most common events in the tirzepatide groups (68% pooled vs. 44% placebo) and were all mild to moderate in severity. Level 2 hypoglycemia (blood glucose <54 mg/dL) occurred in 15% of tirzepatide-treated participants versus 6% with placebo. Rates were highest among those on concurrent basal insulin (29%).1
Limitation: Small sample size (n=99), short 30-week placebo-controlled period, and under-representation of Black youth relative to disease prevalence.
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Clinical Implication
Tirzepatide demonstrated sustained glycemic control and BMI reduction through 52 weeks in youth-onset type 2 diabetes inadequately controlled on metformin and/or basal insulin. Hypoglycemia monitoring is warranted during dose escalation, particularly in patients on concurrent basal insulin.
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Gentamicin should not be used for gram-negative coverage when meningitis is a concern because of poor CNS penetration. It may be continued temporarily for gram-positive synergy but cannot serve as the primary gram-negative agent. The preferred cephalosporin depends on age.
| Age Group | Preferred Agent | Rationale |
|---|---|---|
| Neonates | Cefepime | Best CSF penetration among available cephalosporins |
| Infants & children | Ceftriaxone | Strong clinical track record; narrower spectrum than cefepime |
| All age groups | Avoid ceftazidime | Poor CNS penetration for meningitis |
| Bottom line: When meningitis is on the differential, switch gram-negative coverage to a cephalosporin with reliable CSF penetration: cefepime in neonates and ceftriaxone in older infants and children. |
Court Reverses CDC Vaccine Decisions; ASHP Offers Complimentary Access to Resources
On March 16 a federal district court issued a preliminary injunction blocking revised vaccine recommendations issued by ACIP and the CDC over the past year. The ruling restores the pre-January 2026 immunization schedule and reverses recent changes affecting hepatitis B (including the universal birth dose), rotavirus, influenza, hepatitis A, meningococcal, and COVID-19 vaccine recommendations. The reconstituted ACIP is barred from meeting until the court reviews the legality of member appointments.2
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What This Means in Practice
Clinicians should follow the pre-January 2026 immunization schedule for routine vaccinations including the universal hepatitis B birth dose until further court action.
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- Hannon TS, Chao LC, Barrientos-Pérez M, et al. Efficacy and safety of tirzepatide in children and adolescents with type 2 diabetes (SURPASS-PEDS): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2025;406(10461):1484-1496.
- Court reverses CDC vaccine decisions; ASHP offers complimentary access to resources. ASHP. March 16, 2026. Accessed March 22, 2026. https://news.ashp.org/News/ashp-news/2026/03/16/court-ruling
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