The Link - October 2025

In recent months, headlines about leucovorin (“folinic acid”) as a potential treatment for autism spectrum disorder (ASD) have generated significant misinformation and oversimplified political rhetoric. As a result, pediatricians are increasingly fielding questions from families while trying to sift through conflicting reports to understand what the evidence shows. While early research is promising, particularly for a subset of children with cerebral folate deficiency, this is not a universal therapy and careful, evidence-based guidance is essential.

This article summarizes current findings and offers evidence-based information and prescribing recommendations for pediatricians who may be approached by families about leucovorin.

Coarctation of the aorta (CoA) is a narrowing of the descending aorta that results in decreased blood flow and lower blood pressure in the lower body, while the upper body experiences higher pressures. This obstructive lesion can present with devastating effects in the newborn period. However, other children may have subtle or delayed signs and go undiagnosed for years.

Entering the space of the exam room can be fraught with tensions both known and unknown, agendas spoken and unspoken, fears named and unnamed. At a time when basic facts are questioned, and opinions exist not on different sides of an aisle but on opposite sides of a canyon, we know that emotions run high. The average provider increasingly finds themselves tasked with fulfilling the role of clinician, as well as health care communicator, diplomat, and sometimes hostage negotiator. Fulfilling these roles in a job complicated by the political climate, administrative demands, and complex patient needs means that the average clinician is pulled in multiple directions during routine encounters.

Why does duration matter?

Antimicrobial resistance is a growing global health concern. In the United States alone, antimicrobial resistance leads to more than 2.8 million infections per year with more than 35,000 deaths. Studies have shown that longer antibiotic durations are associated with the emergence of antibiotic resistance. As 85%-95% of antibiotic use occurs in outpatient settings, it is important for ambulatory clinicians to be thoughtful about antibiotic prescribing, including choice of agent, dose, and duration.

Previously, there was a lack of robust scientific data to determine ideal duration to treat many common outpatient infections, and clinicians relied on long (10-14 days) durations based on historical approaches. Growing evidence supports the safety of shortening standard treatment durations for these infections to five to seven days, sometimes even shorter. If a shorter course is found to be as efficacious as a longer course, it is thought to be inherently better, given the improved adherence, decreased side effects, and decreased costs to families.

A 3-year-old girl presented with a solitary lesion below her right eye that had been present for approximately three months.

The lesion initially appeared as a small, skin-colored bump that was thought to be a stye, but it slowly enlarged over time. During the past several weeks, it developed a purple-red discoloration. The lesion was described as mildly tender and occasionally pruritic, but there was no associated fever or systemic symptoms.