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123. Management of suspected bacterial lower urinary tract infection in adult women

for approximately 23% of antibiotic prescriptions where the anatomical site is specified.6 The majority of drug-resistant infections are acquired in the community7 and there is a clear association between antibiotic prescribing in suspected UTI and the development of antimicrobial resistance.8 These factors, the prevalence and burden of UTIs and variation in approaches to diagnosis and management contribute to the need for an evidence-based national guideline in this area. 1.1.1 Prevalence Two national point (...) and limiting unnecessary antibiotic use in patient with suspected (usually self-limiting) LUTI is a crucial step in controlling antimicrobial resistance (AMR). Understanding the evidence supporting LUTI diagnosis and the subsequent appropriate use of alternative (non-antibiotic) strategies which do not compromise clinical outcome and patient well-being is important. The safe and appropriate use of antibiotics is fundamental to national antimicrobial stewardship strategies overseen by the Scottish

2020 SIGN

125. Canadian Urological Association guideline on the management of non-muscle invasive bladder cancer

intravesical BCG and are treated with antituberculous drugs 288 . BCG sepsis requires hospitalization and active treatment (LE 3; strong recommendation) 287 . Adverse effects of BCG and their suggested management are described in Table 6. One study has evaluated whether toxicity is reduced if prophylactic antibiotics (ofloxacin) are administered following intravesical BCG therapy 289 . Although adverse local and systemic effects were reduced from 83.3% to 61.1% (p=0.017) and from 75.9% to 54.4% (p=0.019 (...) ), respectively, further studies are needed to validate the systematic use of antibiotics for this purpose 289 . Furthermore, a study comparing BCG versus epirubicin was unable to show a role of prophylactic isoniazid in reducing side effects during BCG schedule 290 . Other maneuvers that may be utilized in patients who poorly tolerate BCG include decreasing BCG dose and/or intravesical dwell time. 6.2.4 BCG failure Despite adequate BCG administration, up to 40% of high risk patients will experience long-term

2021 Canadian Urological Association

126. Chronic obstructive pulmonary disease in over 16s: diagnosis and management

53 Oral prophylactic antibiotic therapy 54 Long-term oxygen therapy 55 Ambulatory and short-burst oxygen therapy 56 Managing pulmonary hypertension and cor pulmonale 57 Lung volume reduction procedures, bullectomy and lung transplantation 58 Risk factors for COPD exacerbations 59 Self-management, education and telehealth monitoring 60 Context 62 Finding more information and resources 63 Update information 64 Chronic obstructive pulmonary disease in over 16s: diagnosis and management (NG115) © (...) to receive a diagnosis earlier so that they can benefit from treatments to reduce symptoms, improve quality of life and keep them healthy for longer. NICE has also produced: a guideline on antimicrobial prescribing for acute exacerbations of COPD a visual summary covering non-pharmacological management and use of inhaled therapies. Who is it for? Healthcare professionals Commissioners and providers People with COPD and their families and carers Chronic obstructive pulmonary disease in over 16s: diagnosis

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

127. Pancreatitis

acute pancreatitis, investigate other possible causes such as: metabolic causes (such as hypercalcaemia or hyperlipidaemia) prescription drugs microlithiasis hereditary causes autoimmune pancreatitis ampullary or pancreatic tumours anatomical anomalies (pancreas divisum). Pre Prev venting infection enting infection 1.2.3 Do not offer prophylactic antimicrobials to people with acute pancreatitis. Fluid resuscitation Fluid resuscitation 1.2.4 For guidance on fluid resuscitation, see the NICE

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

128. Lyme disease

in this guideline 22 Recommendations for research 23 1 Core outcome set for studies of management of Lyme disease 23 2 Clinical epidemiology of Lyme disease in the UK 23 3 Seroprevalence of Lyme disease-specific antibodies and other tick-borne infections in the UK population 23 4 Antimicrobial management of Lyme disease 24 5 Laboratory tests to diagnose initial and ongoing infection and determine re-infection in the different presentations of Lyme disease in the UK 24 Rationale and impact 26 Awareness of Lyme (...) disease 26 Clinical assessment 27 Laboratory investigations 28 Emergency referral and specialist advice 29 Antibiotic treatment 30 Ongoing symptoms after a course of antibiotics 37 Non-antibiotic management of ongoing symptoms 38 Management for women with Lyme disease during pregnancy and their babies 38 Information for people with Lyme disease 39 Context 41 Finding more information and resources 43 Lyme disease (NG95) © NICE 2019. All rights reserved. Subject to Notice of rights (https

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

129. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)

, the nurse should analyze the cause comprehensively andbe vigilantto notify thedoctor. 8.2.2 Nursing of medication Mild patients generally use antiviral drugs, antibacterial drugs (when bacterial infection exists), and symptomatic treatment. The doctor’s advice should be followed accur- ately and timely. The adverse reactions of oseltamivir mainly include nausea, vomiting, diarrhea, abdominal pain and bronchitis, cough, etc. The adverse reactions of inter- feron are mainly flu-like symptoms such as fever

2020 Covid-19 Ad hoc guidelines

130. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19)

with Staphylococcus aureus is common with in?uenza pneumonia and can be especially virulent [154]. Recent clinical practice guidelines recommend initiating empiric antibacterial therapy in adults with community-acquired pneumonia who test positive for in?uenza [154]. Data from critically ill patients demonstrate secondary infection in about 11% of cases, although the numbers are small. Isolated organisms included gram-negative Intensive Care Medicine GUIDELINES Un-edited accepted proof* © European Society (...) of Intensive Care Medicine and the Society of Critical Care Medicine 2020 31 organisms such as K. pneumoniae, P. aeruganosa, and S. marcescens. On the basis of these limited data it is difficult to determine patterns of superinfection, including the risk of S. aureus infection, commonly seen in influenza. In patients with COVID-19 and hypoxic respiratory failure requiring mechanical ventilation, the panel suggest empiric antimicrobial treatment, on the basis that superinfection is reasonably common

2020 Covid-19 Ad hoc guidelines

131. Critical Care Preparation and Management in the COVID-19 Pandemic

dose (MAC 0.2-0.5) inhalational anaesthesia may be used to maintain sedation with a volatile agent in a low-flow (circle) system. Ventilation Ensure use of an antimicrobial filter within the circuit or placed on the expiratory limb or ventilator exhaust. Note that filters represent an airflow obstruction risk when saturated and routine exchange is advised. Use in-line suction catheters where possible. Avoid inadvertent ventilator circuit disconnections by ensuring all connections are 'tight (...) .' Manual ventilation, or 'hand-bagging' is not advised. Ensure the endotracheal tube is clamped during any planned circuit disconnection, eg switching between ventilators, replacing the antimicrobial filter, or inserting a bronchoscope into the tube. Management of Acute respiratory distress syndrome (ARDS) Follow including: lung protective ventilation conservative fluid management strategy neuromuscular blockade lung recruiting manoeuvres and ventilator modes (eg APRV). Further information from

2020 ICM Anaesthesia COVID-19

132. Covid-19: National supporting guidance for Scottish General Practice

be considered for review by the practice: ? Routine bloods ? Routine BPs ? Other routine work ? Medication Reviews ? Long term condition/ Chronic Disease Reviews ? Review of Enhanced Services eg Minor Surgery, Diabetes etc ? Review all Private Work – routine medical reports, ESA, PIP forms, Insurance medical forms, HGV medicals etc ? Review all Subject Access Requests ? Lower threshold to issue acute medicines on request rather than make contact with patient ? Lower threshold for antibiotic prescribing (...) /watching TV, less concerning than lying in bed not wanting to do anything at all). FEVER/COUGH/SHORTNESS of BREATH/UNWELL: • Use the NHS24 COVID-19 Assessment Tool (see below) COVID 19 GP Assessment Tool V1.0.pdf COVID 19 Self Care V0.6.pdf • Remember, some patients have BP machines and pulse oximeters at home - ask. What is normal for them? • Assess whether they need hospitalisation. If symptoms of pneumonia (green/yellow sputum) prescribe antibiotics. If not send them the COVID-19 Self Care document

2020 Covid-19 Ad hoc guidelines

134. Sepsis and the Emergency Department

of rapid antibiotic treatment, and benefit of care bundles [3,4], however these are the mainstay of management 6. Ensuring audit of these processes, and sepsis care. 7. Ensuring compliance with minimisation of inappropriate antibiotic use* 8. Ensuring staff compliance with Infection Control (including hand hygiene and procedural) policies, and regular audit of this 9. Ensure compliance with Public Health requirements for epidemic and imported disease Those patients being discharged home (e.g. with oral (...) antibiotics, or with a diagnosis of a viral infection (where antibiotics will not help)) should receive clear advice with regards what to do if their condition deteriorates and what specific signs to look out for. *Whilst time to antibiotic for patients with Sepsis is an important measure; for those patients who do not have Sepsis it is important that merely having an abnormal early warning score is not used as an indication to give IV antibiotics ‘just in case’ or for a poorly chosen antibiotic

2020 Royal College of Emergency Medicine

135. Covid-19: Management of emergency department patients

presentations not requiring admission: (taken from same day emergency care (SDEC) guidelines, documents and expert advice from national clinical directors) Expect not to admit overnight the following: Clinical specialty Emergencies that do not require admission Respiratory Pneumonia/COPD without oxygen /NIV requirement. May need initial antibiotics and assessment of response (yet may not require an overnight stay). Asthmatic with PEFR > 75% best or predicted PE without physiological compromise CNS Stroke (...) with clinical decision for oral antibiotic or SDEC i.v. Toxicology Overdose patients with non -toxic levels or asymptomatic 6-12 hrs after ingestion (guided by ToxBase) Other Patients on an end of life pathway or for whom ceiling of care does not require hospitalisation All patients in the above groups who are not admitted must receive appropriate follow up, wherever possible by telephone/video call etc. Advice for patients with flu like symptoms who are not being admitted PHE has published clear guidelines

2020 Covid-19 Ad hoc guidelines

136. Water, sanitation, hygiene and waste management for COVID-19

solution, mixing detergent with water can be used j . The ratio of detergent to water will depend on types and strengths of locally available product. 39 Soap does not need to be antibacterial and evidence indicates that normal soap is effective in inactivating enveloped viruses, such as coronaviruses. 40,41 Alcohol-based hand rub should contain at least 60% alcohol. Such products should be certified and, where supplies are limited or prohibitively expensive, can be produced locally according to WHO (...) , Yeasmin D, Akhter S, et al. Nonrandomized Trial of Feasibility and Acceptability of Strategies for Promotion of Soapy Water as a Handwashing Agent in Rural Bangladesh. The American journal of tropical medicine and hygiene. 2017;96(2):421-9. doi: 10.4269/ajtmh.16-0304. 40. Montville R, Schaffner DW. A meta-analysis of the published literature on the effectiveness of antimicrobial soaps. J Food Prot. 2011;74(11):1875-82. doi: 10.4315/0362-028X.JFP-11-122. 41. Sickbert-Bennett EE, Weber DJ, Gergen-Teague

2020 WHO Coronavirus disease (COVID-19) Pandemic

137. Clinical care of severe acute respiratory infections – Tool kit

transportation 64 5.8 Guideline for specimen transportation 65 5.9 Guide for blood culture collection 66 6. OXYGEN THERAPY 67 Summary 68 References and resources 69 6.1 Algorithm to deliver increasing oxygen in adults 70 6.2 Algorithm to deliver increasing oxygen in children 71 6.3 Checklist to troubleshoot warning signs during oxygen delivery 73 6.4 Algorithm to escalate supportive respiratory therapy 74 7. ANTIMICROBIAL THERAPY 75 Summary 76 References and resources 77 7.1 Anti-COVID-19 therapeutics 79 7.2 (...) Pneumonia severity and empiric antimicrobial therapy 80 7.3 Oseltamivir notice 82 8. SEPSIS AND SEPTIC SHOCK 85 Summary 86 References and resources 87 8.1 Sepsis definitions 89 8.2 Targeted resuscitation in adults in an ICU setting 90 8.3 Initial resuscitation, fluid and vasoactive-inotrope management algorithm for children with septic shock 91 8.4 Guide to the use of vasopressors in septic shock for adults and children 93 8.5 Passive leg raise 94 Clinical Care for Severe Acute Respiratory Infection

2020 WHO Coronavirus disease (COVID-19) Pandemic

138. Laboratory testing for coronavirus disease (COVID-19) in suspected human cases: interim guidance

* For transport of samples for viral detection, use viral transport medium (VTM) containing antifungal and antibiotic supplements. Avoid repeated freezing and thawing of specimens. If VTM is not available sterile saline may be used instead (in which case, duration of sample storage at 2-8 °C may be different from what is indicated above). Aside from specific collection materials indicated in the table also assure other materials and equipment are available: e.g. transport containers and specimen collection

2020 WHO Coronavirus disease (COVID-19) Pandemic

139. Current epidemiology and guidance for COVID-19 caused by SARS-CoV-2 virus, in children: March 2020

-be-used-in-children-when-covid-19-is-suspected March 2020. Korean Society of Infectious Diseases; Korean Society of Pediatric Infectious Diseases; Korean Society of Epidemiology; Korean Society for Antimicrobial Therapy; Korean Society for Healthcare-associated Infection Control and Prevention; Korea Centers for Disease Control and Prevention. Report on the epidemiological features of coronavirus disease 2019 (COVID-19) outbreak in the Republic of Korea from January 19 to March 2, 2020. J Korean Med

2020 Canadian Paediatric Society

140. Assessing the infection prevention and control measures for the prevention and management of COVID-19 in healthcare settings

. 7. Lai CC, Shih TP, Ko WC, et al. 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; (no pagination). Review. 8. Jin YH, Cai L, Cheng ZS, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Military Medical Research 2020; 7 (1) (no pagination). Review. 9. Wax RS

2020 Covid-19 Ad hoc guidelines


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