Background: Nirsevimab was indicated in a population level for all infants < 6 months during the 2023–2024 season in Andalusia (southern Spain). Our aim was to analyse the effect of nirsevimab in the reduction in complications in infants hospitalised for RSV bronchiolitis. Methods: A retrospective observational cohort study was conducted in nine relevant hospitals from all provinces of Andalusia, a region with over 9 million inhabitants. The study sample included 222 children, divided into two groups: infants administered with nirsevimab for passive immunisation (exposure) and infants not administered with nirsevimab. Clinical outcomes were analysed, including the use of respiratory support, the need for admission to paediatric intensive care unit (PICU), and duration of hospitalisation. Bivariate analyses were performed, and multivariable logistic regression models were designed to calculate adjusted odds ratios (ORa), and Cox regression models to calculate adjusted hazard ratios (HRa). Results: Bivariate analysis showed an association between passive immunisation with nirsevimab and a lower frequency of numerous outcomes. After adjustment for relevant covariates, multivariable models showed that the exposure (nirsevimab) reduced nasal cannula use by 64% (13–85%), invasive or non-invasive mechanical ventilation by 48% (1–73%), PICU admission by 54% (14–75%), length of hospitalisation by 30% (8–47%), and length of nasal cannula by 31% (7–49%). A higher risk of co-infection was observed in those immunised (aOR = 3.42, 95%CI: 1.52–7.68). Conclusions: Passive immunisation with nirsevimab may decrease the severity of RSV bronchiolitis in infants requiring hospitalisation, thus contributing tertiary prevention that extends beyond the prevention of RSV infection.

In the post-restrictions COVID-19 period, the incidence of bronchiolitis in infants has increased considerably. Several scores determine the degree of severity of the bronchiolitis episode, but few are clinician-friendly. The main aim of this research was to find the easy-to-use score that most accurately estimated the severity of patients’ infections according to their clinical situations and most accurately predicted the need for hospital admission. An observational cross-sectional study was performed in a reference pediatric hospital during the post-restrictions period of the COVID-19 pandemic (2021 and 2022). A comparison was made between the severity estimate provided by five international acute bronchiolitis scales and the clinical severity of the acute bronchiolitis episode. Three hundred and seventy-seven patients participated in the investigation, with a mean age of 5.68 months; 68.7% of the participants had a mild episode of bronchiolitis, 24.5% had a moderate episode, and 6.9% had a severe episode. The severity estimated by the Tal scale modified by McCallum showed a statistically significant correlation with the clinical severity established by clinical criteria (0.836; p < 0.001). It showed a high correlation with other international scores, such as the Wang score (0.820; p < 0.05) and the Wood–Downes–Ferrés score (0.936; p < 0.001). In the multivariate analysis, the constituent variables of the modified Tal score appeared in the final model that predicts the need for hospital admission. In the context of increased incidence after COVID-19, the Tal score modified by McCallum is an easy-to-use measuring instrument that presents an excellent concordance with the clinical severity estimated at first care contact. It also offers a more significant prediction of the need for hospital admission.

Background: Intracranial suppurative infections (epidural empyema, subdural empyema and brain abscess) are rare but severe pediatric conditions associated with diagnostic delay, neurological sequelae and heterogeneous management. Evidence guiding optimal antibiotic duration, route of administration and adjunctive corticosteroid use remains limited. Methods: We conducted a retrospective multicenter study, including children 2 years. Microbiological diagnosis was achieved in 72%; most isolates included Streptococcus species (42.7%). Empirical antibiotic regimens varied widely; vancomycin was used in 69.3% but frequently discontinued after culture results. The antibiotic route was switched to oral in 21 patients (28.8%), with no increased need for repeat surgical intervention or sequelae. Corticosteroids were used in 49.3% of cases. Sequelae occurred in 29.3%, more frequently in infants (<24 months: 45.5% vs. 22.6%, P = 0.048). Neurological deficits at presentation (odds ratio 8.22) and vomiting (odds ratio 3.55) were associated with sequelae. Mortality was 4.0%. Conclusions: Pediatric intracranial suppurative infections are associated with significant morbidity and marked variability in management across centers. Selected patients may safely transition to oral antibiotics after initial intravenous therapy, although prospective studies are needed. Standardized treatment protocols are required to optimize outcomes and reduce neurological sequelae.