Background: Acute infections in children are prevalent and often lead to antibiotic overuse due to the lack of evidence-based alternative approaches. Phytotherapeutic, homeopathic treatments and bee products are frequently sought as alternative or adjunctive therapies. This scoping review aims to map the existing evidence on the efficacy and safety of these interventions in managing acute pediatric infections. Methods: A comprehensive literature search was conducted across multiple databases to identify studies assessing the use of phytotherapeutic, homeopathic remedies and bee products in children with acute infections. Gastrointestinal infections were not considered since the use of non-antibiotic treatments (probiotics) in these conditions has been widely addressed. Effectiveness: Phytotherapeutic agents and bee products demonstrated promising results in reducing symptom severity and duration in respiratory infections, whereas homeopathic data were limited and inconsistent. Regarding safety, both interventions were generally well-tolerated, with few adverse events reported. No studies or very limited evidence were available for other acute infections such as urinary, dermatological, osteoarticular and nervous system infections. Conclusions: Phytotherapeutic interventions and bee products, particularly in acute upper respiratory tract and acute bronchitis, show encouraging signals of efficacy and safety in pediatric populations. However, evidence for their use in other frequent childhood infections, such as otitis media, or gastrointestinal infections, is almost entirely lacking. In addition, the available literature on homeopathic remedies is scarce and methodologically inconsistent, preventing any firm conclusions. Well-designed, large-scale clinical trials focusing on these underexplored conditions are needed to clarify the potential role of phytotherapeutics and homeopathy in pediatric infectious diseases.

Background: Acute infections in children are prevalent and often lead to antibiotic overuse due to the lack of evidence-based alternative approaches. Phytotherapeutic and homeopathic treatments are frequently sought as alternative or adjunctive therapies. This scoping review aims to map the existing evidence on the efficacy and safety of these interventions in managing acute pediatric infections. Methods: A comprehensive literature search was conducted across multiple databases to identify studies assessing the use of phytotherapeutic and homeopathic remedies in children with acute infections. Gastrointestinal infections were not considered since the use of non-antibiotic treatments (probiotics) in these conditions has been widely addressed. Results: Phytotherapeutic agents demonstrated promising results in reducing symptom severity and duration. Data on homeopathic remedies were limited and inconsistent. Regarding safety, both interventions were generally well-tolerated, with few adverse events reported. No studies or very limited evidence were available for other acute infections such as urinary, dermatological, osteoarticular and nervous system infections. Conclusions: Phytotherapeutic interventions show potential as effective and safe options for managing acute respiratory tract infections. However, the evidence for other infectious conditions and for homeopathic treatments is very limited or inconsistent. Further high-quality, large-scale studies on different types of pediatric infections are needed.

Aims: Fever is one of the most frequent reasons for paediatric consultations. While traditionally managed by reducing body temperature, recent guidelines emphasize alleviating discomfort as the primary therapeutic goal. Although different interventions have been described to manage fever‐associated discomfort in children, their effectiveness and safety has never been systematically analysed. The aim of this study was to review the evidence on the effectiveness and safety of pharmacological and nonpharmacological interventions for managing discomfort in febrile children. Methods: A systematic review was conducted following PRISMA guidelines (PROSPERO: CRD420250655721). PubMed, Embase and Cochrane Library were searched up to 31 January 2025, for studies involving children aged 29 days to 18 years that assessed interventions for fever‐associated discomfort. Randomized controlled trials and observational studies were included. Risk of bias was assessed using Cochrane and STROBE tools. Results were synthesized narratively and grouped according to the type of intervention. Results: Eight studies (5 randomized controlled trials, 3 observational) involving 1877 children were included. Study designs, including dosage of antipyretics and quality varied across studies. Studies comparing ibuprofen and paracetamol provided conflicting results, while combination therapy (paracetamol + ibuprofen) appeared more effective than using a single drug in ‐one trial. Tepid sponging, despite reducing temperature, was associated with increased discomfort. No serious adverse events were reported. Conclusion: Pharmacological treatments appear effective and safe, whereas physical methods offer limited benefit. The available evidence is limited by the small number of studies, methodological heterogeneity, and concerns about risk of bias and outcome measurement inconsistency. New high‐quality studies are needed to guide clinical practice for the management of fever‐associated discomfort in children.

Background: Nirsevimab was introduced to prevent Respiratory Syncytial Virus (RSV) bronchiolitis in infants. Despite its proven effectiveness and similar guidelines across Europe, bronchiolitis reduction varied across Europe. This study explored whether nirsevimab coverage among targeted populations (born in- and out-of-season) was associated to this variability. Methods and findings: We used routinely collected data from 27 pediatric emergency departments across 12 European countries (01/2018–03/2024). All bronchiolitis cases aged <12 months were included. Regions were classified as intervention or control based on nirsevimab implementation. Coverage was obtained from official regional reports. We estimated changes in monthly case using controlled interrupted time-series models accounting for seasonality and temporal trends, by age-groups (0–3 and 3–12 months) and regions during the intervention period (10/2023–03/2024) and examined their correlation to coverage using Pearson’s test. Urinary tract infections served as a control outcome. We included 107,088 bronchiolitis cases. Reductions varied widely across regions and age-groups, from +0.6% (95% CI [−9.4, +20.5]) to −61.0% (95% CI [−67.8, −35.2]). Coverage strongly correlated with bronchiolitis reduction across age-groups and regions ( ρ = −0.86, p = 0.001). Bronchiolitis trends in control countries remained stable, as did urinary tract infections. As an ecological study, causality cannot be inferred and unmeasured regional differences may have contributed to the variability. Conclusions: This multinational interrupted time-series analysis identified coverage as a key factor associated to bronchiolitis reduction across age-groups and European regions. Implementation choices across Europe likely influenced coverage, highlighting that nirsevimab benefits depend not only on its intrinsic efficacy, but also on how effectively it is delivered.