Cough (acute): antimicrobial prescribing

This guideline sets out an antimicrobial prescribing strategy for acute cough associated with an upper respiratory tract infection or acute bronchitis in adults, young people and children. It aims to limit antibiotic use and reduce antibiotic resistance. It was published in February 2019.
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news

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AbstractCough and wheezing are the predominant symptoms of acute bronchitis. Hitherto, the evaluation of respiratory symptoms was limited to subjective methods such as questionnaires. The main objective of this study was to objectively determine the time course of cough and wheezing in children with acute bronchitis. The impact of nocturnal cough on parent ’s quality of life was assessed as secondary outcome. In 36 children (2–8 years), the frequency of nocturnal cough and wheezing was recorded during three nights by automated lung sound monitoring. Additionally, parents completed symptom logs, i.e., the B...
Source: European Journal of Pediatrics - Category: Pediatrics Source Type: research
A large cross-sectional study of UK prescribing data found that the duration of antibiotic prescriptions for common infections in primary care frequently exceeded national guideline recommendations. The most common reason for antibiotic prescribing was for respiratory infections, and more than 80% of prescriptions for acute cough and bronchitis, acute sore throat, acute otitis media and acute exacerbations of COPD were for longer than recommended. Substantial reductions in antibiotic exposure can be achieved by prescribing antibiotics in line with NICE and Public Health England guidance on managing common infections.
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news
Publication date: July–August 2019Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 7, Issue 6Author(s): Sarah Diver, Richard J. Russell, Christopher E. BrightlingEosinophilic airway inflammation is observed in 30% to 50% of chronic cough sufferers. It is a common feature of asthma and upper airway cough syndrome, and it is required in the diagnosis of nonasthmatic eosinophilic bronchitis. Our understanding of the mechanisms underlying allergic and nonallergic eosinophilic inflammation have evolved tremendously in the last 2 decades, but the cause of this inflammation in any individual is of...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
A 42-year-old male presented with cough productive of thick secretions that had the appearance of branching airway casts (Figures  1 and 2). Symptoms were worse upon consumption of foods with a high fat content and conversely, improved with a low fat diet. Bronchoscopy with bronchoalveolar lavage revealed milky fluid return from the right middle and lower lobes with bronchial casts in the right middle lobe. The bronchoalveola r lavage triglyceride level was 479 mg/dL and histopathologic analysis of the casts with Oil Red O staining showed 76% lipid-laden macrophages consistent with chyloptysis.
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Medical image Source Type: research
A 37-Year-Old Man With Pleuritic Chest Pain. Chest. 2019 Jul;156(1):e15-e21 Authors: Galant-Swafford J, Light M, Onaitis MW, Rawlings SA, Fierer J, Landsberg JW Abstract CASE PRESENTATION: A 37-year-old man with poorly controlled type 2 diabetes presented with severe right-sided pleuritic chest pain, respiratory splinting, and cough. Two weeks earlier, he had been evaluated at an urgent care for cough and was prescribed a 5-day course of azithromycin for bronchitis. He then presented to our ED reporting mild, right-sided pleuritic chest pain. Vital signs were normal, and his chest radiograph show...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
We report the case of a male schoolchild with a history of complex congenital heart disease, treated with palliative surgery, evaluated in the emergency department for cough and respiratory distress. The mother referred expulsion of gelatinous material after coughing. During clinical evaluation, expulsion of bronchial casts was evidenced, suggesting a plastic bronchitis. He underwent a diagnostic and therapeutic bronchoscopy and received initial treatment with respiratory therapy, nebulized hypertonic saline solution, mucolytics, dornase alpha and nebulized heparin. The hospitalization revealed a stenosis of the right pulm...
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
Publication date: Available online 6 June 2019Source: Pulmonary Pharmacology &TherapeuticsAuthor(s): Li Long, Kefang LaiAbstractChronic cough is one of the most common complains for patients seeking medical attention in both general practice and respiratory specialist clinics. Cough variant asthma, eosinophilic bronchitis, upper airway cough syndrome, as well as gastro-esophageal reflux disease are common conditions associated with chronic cough, and cough variant asthma, eosinophilic bronchitis account for a higher proportion of patients with chronic cough in China than in Western countries. An older female predominan...
Source: Pulmonary Pharmacology and Therapeutics - Category: Respiratory Medicine Source Type: research
CONCLUSIONS: It is not clear from the evidence included in this review whether there is a difference in efficacy or safety between different classes or regimens of prophylactic antibiotic, given for 12 to 13 weeks to people with COPD. Whilst no head-to-head comparisons of antibiotic resistance were identified, concerns about this continue. The sample size in this review is small and both included studies are of short duration. Thus, there is considerable uncertainty in effects observed and the effects of different prophylactic antibiotics requires further research. PMID: 31125127 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
CONCLUSIONS: In participants with chronic bronchitis or COPD, we are moderately confident that treatment with mucolytics leads to a small reduction in the likelihood of having an acute exacerbation, in days of disability per month and possibly hospitalisations, but is not associated with an increase in adverse events. There appears to be limited impact on lung function or health-related quality of life. Results are too imprecise to be certain whether or not there is an effect on mortality. Our confidence in the results is reduced by high levels of heterogeneity in many of the outcomes and the fact that effects on exacerbat...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
A set of  measles outbreaks in Washington state, New York City, and elsewhere, is making national headlines and frightening parents around the United States. Counter-intuitively, measles making the news is a sign of progress. Not long ago, measles was so common that it was simply not newsworthy. Suffer ing from the extremely infectious disease, which causes spotty rashes and a hacking cough, was widespread and often deadly.It was once the case that even royalty fell victim to diseases now easily preventable with routine shots given during childhood.  Measles killed the un-vaccin...
Source: Cato-at-liberty - Category: American Health Authors: Source Type: blogs
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