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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AbstractObjectivesHypertrophic pachymeningitis (HP) is a rare complication in patients with anti-neutrophil antibody-associated vasculitis (AAV); its clinical features, incidence, and risk factors remain unknown. We aimed to clarify the prevalence, clinical features, and factors associated with new-onset HP in patients with AAV.MethodA retrospective cohort study involving 93 patients with AAV was conducted. HP incidence between patients with granulomatosis with polyangiitis (GPA) and those with microscopic polyangiitis (MPA) was compared to investigate risk factors associated with HP. We performed only univariate analysis ...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research
Conclusions: In AOM complicated by serous labyrinthitis, density of perilymph may increase due to direct penetration of cytokines and other inflammatory mediators from the middle ear into perilymph and breakdown of blood–labyrinth barrier that causes vascular leakage of serum albumin into perilymph. The density difference between perilymph and endolymph makes the semicircular canal gravity sensitive. A buoyant force is also generated by gravity, causing indentation of endolymphatic membrane in the ampulla and cupula displacement. Thus, at the early stage of serous labyrinthitis, a head-roll test may elicit persiste...
Source: Otology and Neurotology - Category: ENT & OMF Tags: VESTIBULAR DISORDERS Source Type: research
Updated Date: Mar 18, 2019 EST
Source: DailyMed Drug Label Updates - Category: Drugs & Pharmacology Source Type: alerts
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