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282. Ibrutinib (new therapeutic indication, chronic lymphocytic leukaemia) - Benefit assessment according to §35a Social Code Book V

as planned. Pretreatment not allowed: ? any pretreatment with systemic anticancer treatment against CLL/SLL premedication and concomitant treatment ? obinutuzumab: mandatory prophylaxis of infusion reactions: analgesics, antipyretics, antihistamines, corticosteroids ? TLS prophylaxis in patients with high tumour loads: mandatory fluid intake; allopurinol or equivalent ? patients with neutropenia: strong recommendation for antimicrobial, antiviral and antimycotic prophylaxis further permitted concomitant

2020 Institute for Quality and Efficiency in Healthcare (IQWiG)

283. Elotuzumab (multiple myeloma) - Benefit assessment according to §35a Social Code Book V

prophylaxis (e.g. acetylsalicylic acid, low molecular weight heparin, vitamin K antagonists) as needed: ? treatment of infusion reactions (e.g. IV corticosteroids, H2 inhibitors, leukotriene inhibitors), oxygen inhalation, epinephrine, bronchodilators, oral antiviral and antimicrobial prophylaxis, antiemetics, bisphosphonates, erythropoietin, G-CSF for neutropenia not allowed: ? other antimyeloma therapies within 14 days before start of treatment ? other steroids than dexamethasone, low-dose prednisone

2020 Institute for Quality and Efficiency in Healthcare (IQWiG)

285. Ivacaftor (combination with ivacaftor/tezacaftor, cystic fibrosis, 12 years and older, with F508del mutation, heterozygous) - Benefit assessment according to §35a Social Code Book V

(including dornase alfa, as well as pancreatin and antibiotic therapy and sodium chloride) at the time point of study entry. The available data also suggest that individual patients initiated concomitant medication after the first intake of the study medication (e.g. antibiotic therapy and physiotherapy). It cannot be inferred from the data, however, whether and how many patients had their concomitant treatment adjusted, for example in the sense of an increase in dose or frequency. In summary, it remains (...) Placebo + BSC IVA + TEZA/IVA + BSC Placebo + BSC N a = 83 N a = 80 N a = 78 N a = 81 VX14-661-108 Type of the RF mutation Class V non-canonical splice mutations 50 (60.2) 48 (60.0) 45 (57.7) 49 (60.5) Class II to IV missense RF mutations 33 (39.8) 32 (40.0) 33 (42.3) 32 (39.5) Treatment before study inclusion e , n (%) Inhaled antibiotics 26 (31.3) 23 (28.8) 23 (29.5) 27 (33.3) Inhaled bronchodilators 74 (89.2) 71 (88.8) 67 (85.9) 70 (86.4) Inhaled hypertonic saline 43 (51.8) 39 (48.8) 35 (44.9) 45

2020 Institute for Quality and Efficiency in Healthcare (IQWiG)

286. Ivacaftor (combination with ivacaftor/tezacaftor, cystic fibrosis, 12 years and older, with F508del mutation, homozygous) - Benefit assessment according to §35a Social Code Book V

comparison: ivacaftor + tezacaftor/ivacaftor vs. lumacaftor/ivacaftor (continued) Study Characteristics Category VX14-661-106 VX12-809-103 VX12-809-104 IVA + TEZA/IVA a Placebo a LUMA/IVA a Placebo a LUMA/IVA a Placebo a N a = 248 N a = 256 N a = 182 N a = 184 N a = 187 N a = 187 Treatment before study inclusion f , n (%) Dornase alfa 166 (66.9) 185 (72.3) 123 (67.6) 135 (73.4) 150 (80.2) 146 (78.1) Inhaled antibiotics 136 (54.8) 160 (62.5) 113 (62.1) 122 (66.3) 112 (59.9) 136 (72.7) Inhaled (...) , bronchodilators, antibiotics, analgesics and vitamin preparations. Treatment with inhaled saline solution was not explicitly excluded in all studies. The proportion of patients under the respective concomitant medication remained largely unchanged before and after the first intake of the study medication (see Table 9). A clear increase in concomitant medication after the first intake of the study medication in all arms of the 3 studies was shown, for example, for antibiotics (including ciprofloxacin

2020 Institute for Quality and Efficiency in Healthcare (IQWiG)

287. PICO negative pressure wound therapy for closed surgical incision wounds

should have post-surgical care that involves: applying wound dressings using aseptic techniques wound cleaning with sterile saline for up to 48 hours and cleaning with tap water afterwards antibiotics, if an SSI is suspected. If dead or infected tissues seem to be slowing down the healing process, debridement (which may involve surgery) can be used to remove the dead tissue. This is in addition to preventive measures at the pre- and intra-operative stages of a surgical procedure. In some cases

2019 National Institute for Health and Clinical Excellence - Advice

289. Examining the Role of Coaching in Health-system Transformations

for organizational change. They described working closely with executives in an organization over a six-week to six-month period, dependent on how complex the change was, to support the executive to adopt the necessary skills to implement a change. Locally, key informants in Ontario described how some of the projects initiated by the ARTIC program were focused at the level of enabling change at an organizational level, such as the ASP ARTIC CHILL program which established antimicrobial stewardship programs

2020 McMaster Health Forum

292. European surveillance of Clostridioides (Clostridium) difficile infections - surveillance protocol version 2.4

is provided on page 2 of Form H. Defined daily doses (DDDs) per 100 patient-days in the previous calendar year, for selected antimicrobial agents (optional): Provide the DDDs during the previous calendar year (i.e. January–December) for the entire hospital. If it is only possible to provide data for one antimicrobial group, provide this for fluoroquinolones (Anatomical Therapeutic Chemical Classification System (ATC) J01MA). Otherwise, also provide this data for the total ‘antibacterials for systemic use (...) specific for CDI (optional): ___ % Which of the following persons received education in reduction of CDI (optional; tick all that apply): clinicians, nursing staff, environmental cleaning staff, other support staff, patients, visitors, other (please specify______________) Antimicrobial consumption during this previous calendar year Antimicrobial class (ATC code) N of defined daily doses (DDDs)/100 patient-days Fluoroquinolones (J01MA; optional, recommended) All antibacterials for systemic use

2020 European Centre for Disease Prevention and Control - Technical Guidance

293. Rapid tests for group A streptococcal infections in people with a sore throat

This guidance covers using rapid tests for group A streptococcal (strep A) infections in people aged 5 and over with a sore throat. For children under 5, assessment is described in NICE's guideline on fever in under 5s: assessment and initial management. People who are at higher risk of complications, for example women who are pregnant or who have just had a baby, or people who are immunocompromised, should be offered antibiotics in line with NICE's guideline on antimicrobial prescribing for acute sore (...) throat. This is because their effect on improving antimicrobial prescribing and stewardship, and on patient outcomes, as compared with clinical scoring tools alone, is likely to be limited. Therefore, they are unlikely to be a cost-effective use of NHS resources. Wh Why the committee made these recommendations y the committee made these recommendations Unnecessary use of antibiotics can contribute to antimicrobial resistance, which is a public health concern. NICE's guideline on antimicrobial

2019 National Institute for Health and Clinical Excellence - Diagnostics Guidance

294. What is the evidence for mass gatherings during global pandemics

-Cheng Laia, Tzu-Ping Shih, Wen-Chien Ko. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. International Journal of Antimicrobial Agents. 2020: 55(3):105924 doi.org/10.1016/j.ijantimicag.2020.105924 19 Risk-informed decision-making for mass gatherings during COVID-19 global outbreak. (accessed 18 March 2020) 14 - 16 September 2020 The 8th international conference in Oxford, UK. 14 - 18 September 2020 Workshop

2020 Oxford COVID-19 Evidence Service

295. Rapid diagnosis strategy of community-acquired pneumonia for clinicians

to essential decision making to admit or not. We recommend documenting that on examination a ‘limited examination’ was performed ( abbreviated to O/E LE ). *pulse oximeter provides a simple way to measure heart rate and can aid the assessment of the deteriorating patient. the prognosis of patients with CAP independently of severity scores. ** see for the antibiotic strategy. *** Red Flag: Independent predictors of pleural effusion are dullness to percussion and asymmetric chest expansion. EVIDENCE

2020 Oxford COVID-19 Evidence Service

296. Covid-19: Differentiating viral from bacterial pneumonia

is caused by a virus, antibiotics are ineffective. Do not offer an antibiotic for treatment or prevention of pneumonia if: COVID‑19 is likely to be the cause and symptoms are mild. Offer an oral antibiotic for the treatment of pneumonia in people who can or wish to be treated in the community if: the likely cause is bacterial or it is unclear whether the cause is bacterial or viral and symptoms are more concerning or they are at high risk of complications because, for example, they are older or frail (...) , or have a pre-existing comorbidity such as immunosuppression or significant heart or lung disease (for example bronchiectasis or COPD), or have a history of severe illness following a previous lung infection. When starting antibiotic treatment, the first-choice oral antibiotic is: doxycycline 200 mg on the first day, then 100 mg once a day for 5 days in total (not in pregnancy) alternative: amoxicillin 500 mg 3 times a day for 5 days. Do not routinely use dual antibiotics. For the choice

2020 Oxford COVID-19 Evidence Service

297. Frontline health workers in COVID-19 prevention and control: rapid evidence synthesis

and not for drinking. Drinking alcohol doesn’t kill the virus. It’s a disease of affluence Anyone can be infected with new corona virus irrespective of their social status Antibiotics effective in preventing and treating the new coronavirus NO, antibiotics do not work against viruses. References 1. Ameme DK, Nyarko KM, Afari EA, et al. Training Ghanaian frontline healthcare workers in public health surveillance and disease outbreak investigation and response. Pan Afr Med J 2016;25:2. 2. Armstrong-Mensah EA, Ndiaye

2020 Covid-19 Ad hoc papers

298. Chloroquine and hydroxychloroquine: Current evidence for their effectiveness in treating COVID-19

trial. International Journal of Antimicrobial Agents, p.105949. 3) Sahraei, Z., Shabani, M., Shokouhi, S. and Saffaei, A., 2020. Aminoquinolines Against Coronavirus Disease 2019 (COVID-19): Chloroquine or Hydroxychloroquine. International Journal of Antimicrobial Agents, p.105945. 4) Chauhan, A. and Tikoo, A., 2015. The enigma of the clandestine association between chloroquine and HIV‐1 infection. HIV medicine, 16(10), pp.585-590. 5) Keyaerts, E., Li, S., Vijgen, L., Rysman, E., Verbeeck, J., Van (...) Ranst, M. and Maes, P., 2009. Antiviral activity of chloroquine against human coronavirus OC43 infection in newborn mice. Antimicrobial agents and chemotherapy, 53(8), pp.3416-3421. 6) Vincent, M.J., Bergeron, E., Benjannet, S., Erickson, B.R., Rollin, P.E., Ksiazek, T.G., Seidah, N.G. and Nichol, S.T., 2005. Chloroquine is a potent inhibitor of SARS coronavirus infection and spread. Virology journal, 2(1), p.69. 7) Liu, J., Cao, R., Xu, M., Wang, X., Zhang, H., Hu, H., Li, Y., Hu, Z., Zhong, W

2020 Oxford COVID-19 Evidence Service

299. Covid-19: a remote assessment in primary care Full Text available with Trip Pro

practice. This article is intended as a broad orientation to a COVID-19 consultation. It does not cover every clinical eventuality, and should not be used as an official guideline for the management of a COVID-19 patient. National and local guidance are being urgently produced, and further research is being undertaken on specific aspects of management such as use of antibiotics. What you should cover Telephone or video? The telephone is a familiar and dependable technology, which is adequate for many (...) , comorbidities, and social support. The patient in the vignette, for example, has asthma so will need advice to step up treatment if her peak flow drops. Those with COPD may need antibiotics for an infective exacerbation. A social safety net will be important in patients living alone. Explain any arrangements for self swabbing (not currently being offered in the UK, but this may change), dropping off specimens, and picking up medication. If the patient has covid-19 symptoms, remind them to get someone

2020 Covid-19 Ad hoc papers

300. Assessment of the Global Covid-19 Case Fatality Rates?

); highest rates of antibiotic resistance deaths in Europe which might contribute to increased pneumonia deaths (Italy tops the EU for antibiotic-resistance deaths w in the EU). Smoking also seems to be a factor associated with poor survival – in Italy, 24% smoke, 28% men. In the UK, for instance, 15% are current smokers. Comparison with Swine Flu The overall (10 weeks after the first international alert) with pandemic H1N1 influenza varied from 0.1% to 5.1% depending on the country. The WHO reported (...) to Germanys estimate, currently 0.2%). The CFR is likely to be higher in smokers, the immunosuppressed, those with co-morbidities, and in countries with less developed health systems. We have no understanding of the impact of co-infections, which may raise the CFR rates and the effect of early treatment of bacterial complications and antibiotic resistance levels. 14 - 16 September 2020 The 8th international conference in Oxford, UK. 14 - 18 September 2020 Workshop for health professionals developing

2020 Oxford COVID-19 Evidence Service

Evidence-based Synopses

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