Top 5 respiratory disorders articles of 2025

Welcome to another edition of Countdown to 2026, and thank you for visiting the Contemporary Pediatrics website throughout 2025. Below, take a look at the top respiratory disorders stories published this year, and catch up on anything you may have missed.

1. Nirsevimab demonstrates high effectiveness against RSV in healthy term infants

A large observational cohort study conducted at Kaiser Permanente Northern California during the 2023–2024 RSV season found that nirsevimab was highly effective in preventing respiratory syncytial virus–associated lower respiratory tract disease in healthy term infants. Among nearly 32,000 infants, those who received nirsevimab had substantially lower rates of PCR-confirmed RSV LRTD and RSV-related hospitalizations compared with nonimmunized infants, along with fewer emergency department visits and overall medical encounters. The findings were consistent across multiple sensitivity analyses and showed no association with protection against non-RSV infections, supporting the specificity of the effect. Investigators concluded that these real-world data support routine nirsevimab use for RSV prevention in healthy term infants, in line with current immunization recommendations.

2. Surge in pediatric Mycoplasma pneumoniae hospitalizations reported in 2024

An analysis of national Pediatric Health Information System data found a marked increase in Mycoplasma pneumoniae–associated community-acquired pneumonia hospitalizations among US children in 2024, following several years of low circulation during the COVID-19 pandemic. In 2024, M. pneumoniae accounted for approximately one-third of pediatric CAP hospitalizations, with notable increases across all age groups, including infants and young children. Despite higher hospitalization rates, measures of illness severity, including length of stay, intensive care unit admission, and in-hospital mortality, declined compared with prior years. Investigators noted that the surge may reflect increased population susceptibility and emphasized the importance of considering and testing for M. pneumoniae during periods of high transmission to guide appropriate antimicrobial therapy.

3. RSV prophylaxis: Palivizumab, nirsevimab, and more

Respiratory syncytial virus is a leading cause of hospitalization in infants and young children, prompting the development of multiple preventive strategies, including monoclonal antibodies and vaccines. Palivizumab and nirsevimab provide passive immunity through RSV-specific monoclonal antibodies, with palivizumab primarily reserved for high-risk infants and nirsevimab approved for all infants during their first RSV season because of its longer duration of protection and broader indication. Nirsevimab is administered as a single dose and has demonstrated reductions in RSV-associated lower respiratory tract infection and hospitalization, whereas palivizumab requires monthly dosing and is limited by cost and narrower eligibility. In addition, RSV vaccines are available for older adults, and maternal vaccination with Abrysvo during late pregnancy has been shown to reduce RSV-related hospitalizations in infants through passive antibody transfer. Collectively, these interventions provide complementary options to reduce RSV-associated morbidity across pediatric, maternal, and older adult populations.

4. Climate change: Challenges faced by the pediatric population

Climate change poses a growing public health threat with disproportionate effects on children, who are uniquely vulnerable because of developing organ systems, higher relative exposures, and dependence on caregivers. Evidence links climate-related stressors—such as extreme heat, worsening air quality, wildfires, flooding, and shifting vector habitats—to increased risks of pediatric respiratory disease, heat-related illness, malnutrition, infectious diseases, kidney stones, injuries, and adverse mental health outcomes, with additional impacts beginning as early as fetal development. These harms are amplified by social determinants of health, particularly among children from low-income and marginalized communities. Pediatric nurses play a critical role in climate harm reduction by educating families, supporting management of climate-sensitive conditions, promoting preparedness for extreme weather, addressing mental health needs, and advocating for equitable, evidence-based policies. Integrating climate literacy, anticipatory guidance, and public health frameworks such as the CDC’s BRACE model can help mitigate risks and support resilience in pediatric populations as climate-related health threats intensify.

5. FDA approves pediatric indication for SONU wearable device to treat nasal congestion

The US Food and Drug Administration has approved an expanded pediatric indication for the SONU Band, an AI-enabled, drug-free, at-home device for the treatment of moderate to severe nasal congestion associated with allergic and nonallergic rhinitis in individuals aged 12 years and older. Authorized through the FDA De Novo pathway, the SONU Band uses personalized acoustic vibrational therapy generated from smartphone-based facial scans to deliver targeted sound frequencies intended to reduce nasal swelling and improve sinus drainage. Clinical data from a prospective study in adults with obstructive sleep apnea demonstrated reductions in nasal symptoms and improvements in continuous positive airway pressure adherence, supporting its potential role in relieving congestion. The expanded indication provides a noninvasive alternative for pediatric patients and families seeking options that avoid pharmacologic therapies, including intranasal steroids.