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Thank you for visiting the Contemporary Pediatrics® website. Take a look at some of our top stories from the week (Monday, May 5, to Friday, May 9, 2025), and click on each link to read and watch anything you may have missed.
On May 7, 2025, ARS Pharmaceuticals announced that neffy, the epinephrine nasal spray, is now available by prescription in the US for children aged ≥4 years who weigh between 33 and <66 lbs to treat Type I allergic reactions, including anaphylaxis. The announcement follows the March 6, 2025 FDA approval expanding neffy’s indication to this younger weight group, making it the first and only needle-free epinephrine treatment for children under 66 lbs. Originally approved on August 9, 2024, for children weighing ≥66 lbs, neffy offers a portable, easy-to-use alternative to epinephrine auto-injectors, with no needle and demonstrated ease-of-use in human factor studies. It also has a 24-month shelf life and remains stable for 3 months at temperatures up to 122°F. Approval was supported by pharmacokinetic and pharmacodynamic data showing bioequivalence to injectable epinephrine in adults and children.
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The case involves an 18-day-old female presenting to the emergency department with intermittent cyanosis, suspected apnea, decreased feeding, and a history of retractions, nasal flaring, and grunting. Vital signs revealed hypoxemia and tachypnea, with oxygen saturation levels fluctuating between 65% and 100% on room air. A chest X-ray image was provided for diagnostic evaluation. Readers are encouraged to vote on the most likely diagnosis and return to the site for the full case details, differential diagnoses, and final diagnosis.