NICE Bites; Respiratory Tract Infections (acute) antimicrobial prescribing

This monthly prescribing bulletin summarises key recommendations from NICE guidance. The latest topics are acute sore throat and otitis media.
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news

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Saying that sore throats are simple has become a trope, as thus many physicians do not seem to have a thoughtful approach to adolescent/young adult pharyngitis.  As the author of the Centor Score, I would like you to consider these points when seeing sore throat patients. The most important use of the score involves identifying those who need neither diagnostic tests nor antibiotics.  Too many urgent cares run a group A rapid strep test on everyone with a sore throat. The score is meant for acute (3 day or less) sore throat symptoms. The score stratifies adolescent/young adults with bacterial pharyngitis –...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs
Discussion “Chiropractic is a health care profession concerned with the diagnosis, treatment, and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health.” Some people look at chiropractic care solely as spinal manipulative therapy (SMT) or manipulation. Chiropractic physicians also offer a variety of other treatments including nutritional advice, dietary or herbal supplements, therapeutic exercise, posture correction and behavioral counseling. Spinal muscle therapy or spinal manipulation is one of the most common complementary, integrative, and alternati...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
Abstract Malignant Otitis externa is a necrotizing condition of external ear involving causing the osteomyelitis of the bone and surrounding soft tissue leading to multiple cranial nerve palsies. Though most patients respond to oral ciprofloxacin but due to emerging resistance cases of refractory malignant otitis externa which are unresponsive to antibiotic therapy for at least 6  weeks are being encountered lately. A study of 20 patients of refractory malignant otitis Externa was conducted at a tertiary care centre in north India; 10 patients were randomly allotted in group A and group B each. Group A was subjected...
Source: Indian Journal of Otolaryngology and Head and Neck Surgery - Category: ENT & OMF Source Type: research
In 2007, Matthys and colleagues published a classic article: Differences Among International Pharyngitis Guidelines: Not Just Academic Jan Matthys, Marc De Meyere, Mieke L. van Driel, An De Sutter Ann Fam Med. 2007 Sep; 5(5): 436–443. doi: 10.1370/afm.741 PMCID: PMC2000301 RESULTS We included 4 North American and 6 European guidelines. Recommendations differ with regard to the use of a rapid antigen test and throat culture and with the indication for antibiotics. The North American, French, and Finnish guidelines consider diagnosis of group A streptococcus essential, and prevention o...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs
CONCLUSIONS: For many clinical outcomes, there were no differences between prescribing strategies. Symptoms for acute otitis media and sore throat were modestly improved by immediate antibiotics compared with delayed antibiotics. There were no differences in complication rates. Delaying prescribing did not result in significantly different levels of patient satisfaction compared with immediate provision of antibiotics (86% versus 91%) (moderate quality evidence). However, delay was favoured over no antibiotics (87% versus 82%). Delayed antibiotics achieved lower rates of antibiotic use compared to immediate antibiotics (31...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
CONCLUSIONS: Some parents have misperceptions about antibiotic use for acute respiratory infections, highlighting the need for improved communication during visits, including shared decision making to address overoptimistic expectations of antibiotics. Such communication should be one of several strategies that is used to reduce antibiotic use. PMID: 28289114 [PubMed - in process]
Source: Annals of Family Medicine - Category: Primary Care Authors: Tags: Ann Fam Med Source Type: research
CONCLUSIONS To our knowledge, this is the first report of the surgical treatment of sellar tumors by means of a minimally invasive TORS. This approach using the da Vinci Surgical System seems feasible and constitutes an innovative neurosurgical technique that may avoid the adverse side effects and technical disadvantages of the classic transsphenoidal route. Moreover, TORS allows an inferosuperior approach to the sella turcica, which is a key point, as the tumor is approached in the direction of its growth. PMID: 28009229 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery - Category: Neurosurgery Authors: Tags: J Neurosurg Source Type: research
Discussion Tinnitus is derived from the Latin word tinnire which means to ring but in general practice it means any perceived sound that is not generated externally. It is a common problem in adults. In children it is described as being commonly overlooked as children do not spontaneously report it. It is felt that children may consider the sound normal, or are easily distracted and therefore forget about it. Children can accurately describe the sounds they hear and use words such as buzz, ring, hum, swish, whish, blow or beep. Spontaneously reported tinnitus is ~6.5% and increases to 34% when children are specifically que...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
This report describes the first case of symptomatic ischaemic stroke secondary to SBO in an immunocompetent child. We review the literature of the management and the potential cerebrovascular complications of central SBO in children secondary to otolaryngological infection.
Source: International Journal of Pediatric Otorhinolaryngology - Category: ENT & OMF Authors: Tags: Case Report Source Type: research
Authors: Magin PJ, Morgan S, Tapley A, Davis JS, McArthur L, Henderson KM, Mulquiney KJ, Dallas A, Davey AR, Scott J, van Driel ML Abstract Over-prescription of antibiotics for non-pneumonia respiratory tract infections (RTIs) is a major concern in general practice. Australian general practice registrars (trainees) have inappropriately high rates of prescription of antibiotics for RTIs. The 'apprenticeship' educational model and the trainee-trainer relationship are drivers of this inappropriate prescribing. We aimed to reduce registrars' non-pneumonia RTI antibiotic prescribing via an educational intervention (a 90...
Source: Education for Primary Care - Category: Primary Care Tags: Educ Prim Care Source Type: research
More News: Health | National Institute for Health and Clinical Excelle | Otitis | Otitis Media | Respiratory Medicine | Sore Throat