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1941. Long-acting reversible contraception

of STIs any STIs in women who request it. [2005] If testing for STIs is not possible, or has not been completed, prophylactic antibiotics should be given before IUD insertion in women at increased risk of STIs. [2005] Women with identified risks associated with uterine or systemic infection should have investigations, and appropriate prophylaxis or treatment before insertion of an IUD. [2005] Specific groups, medical conditions and contr Specific groups, medical conditions (...) to Notice of rights ( conditions#notice-of-rights). Page 18 of 35any STIs in women who request it. [2005] If testing for STIs is not possible, or has not been completed, prophylactic antibiotics should be given before IUS insertion in women at increased risks of STIs. [2005] Women with identified risks associated with uterine or systemic infection should have investigations, and appropriate prophylaxis or treatment before insertion of the IUS. [2005

2005 National Institute for Health and Clinical Excellence - Clinical Guidelines

1942. Postnatal care up to 8 weeks after birth

] [2006] 1.3.36 If signs and symptoms of mastitis continue for more than a few hours of self management, a woman should be advised to contact her healthcare professional again (urgent action). [2006] [2006] 1.3.37 If the signs and symptoms of mastitis have not eased, the woman should be evaluated as she may need antibiotic therapy (urgent action). [2006] [2006] In Inv verted nipples erted nipples 1.3.38 Women with inverted nipples should receive extra support and care to ensure successful

2006 National Institute for Health and Clinical Excellence - Clinical Guidelines

1947. Statement on new oral cholera and travellers' diarrhea vaccination

or health professionals working in endemic countries) may benefit from immunization (21) . A detailed, travel-related risk assessment should be made to determine those travellers most likely to benefit from vaccination. Recommended Usage: Travellers' Diarrhea Indications for the oral BS-WC vaccine are limited because of the following: 1) most episodes of travellers' diarrhea are usually mild and self-limited; 2) therapeutic options (oral rehydration, dietary management, antimotility, and antibiotic (...) ' diarrhea are as follows: 1) education about the ingestion of safe food and beverages[A 11]; 2) water purification[A11]; 3) chemoprophylaxis with nonantibiotic drugs or antibiotics[B11]; and 4) vaccination. The BS-WC vaccine provides limited short-term protection (approximately 3 months) against diarrhea caused by ETEC [A1] . Vaccination with BS-WC as a prevention strategy for ETEC travellers' diarrhea is of limited value and cannot be routinely recommended for the majority of travellers, based

2005 CPG Infobase

1948. Statement on cruise ship travel

is available, antibiotic treatment is usually effective (43) . Legionella must be considered in the differential diagnosis of acute febrile illness, bronchitis or pneumonia in someone currently taking, or who has recently completed, a cruise. C. Rubella To date, outbreaks of rubella have been limited to crew members on cruise ships. In 1997, two clusters of rubella infections were reported on commercial cruise ships. In one outbreak, 16 of 385 crew (4%) aboard ship were infected; half were asymptomatic (...) . Pneumococcal vaccine: an emerging consensus. Editorial. Ann Intern Med 1988;108(5):757-59. 41. Rowbotham TJ. Legionellosis associated with ships: 1977-1997. Commun Dis Public Health 1998;1(3). 42. Minooee A, Rickman LS. Infectious diseases on cruise ships. Clin Infect Dis 1999;29(4):737-43. 43. Edelstein PH. Antimicrobial chemotherapy for Legionnaire's disease: a review. Clin Infect Dis 1995;21(3):S265-70. 44. Centers for Disease Control and Prevention. Rubella among crew members of commercial cruise ships

2005 CPG Infobase

1950. Statement on persistent diarrhea in the returned traveller

, Campylobacter , various E. coli species, including enteroaggregative types, and other organisms more commonly associated with acute illness can, rarely, cause persistent diarrhea and respond to appropriate antimicrobial therapy . Clostridium difficile enters the differential diagnosis in a substantial proportion of travellers who have received antimicrobial treatment for any reason, including the use of doxycycline for malaria prophylaxis. It usually responds to standard therapy with metronidazole (...) or vancomycin given orally, but relapse occurs relatively frequently. Tropical sprue is an uncommon, acquired malabsorption syndrome believed to involve bacterial overgrowth . Prolonged antimicrobial therapy combined with supplementation of micronutrients, especially folate, is usually effective. Protozoa Giardia lamblia is a very widely distributed parasite, which can cause a subacute to chronic small bowel infection that may be asymptomatic or associated with diarrhea or even malabsorption. Metronidazole

2006 CPG Infobase

1951. Statement on travellers and sexually transmitted infections

are resistant to standard antibiotics . Beta lactamase-producing strains of Neisseria gonorrhoeae (NG) are prevalent in Africa, the Caribbean, and Asia . In Canada, the rate of penicillinresistant NG rose from 8.7% in 1992 to 15% to 22% in 2003 . Similarly, resistance to other antibiotics has been reported for NG in many other countries of the industrialized world . Chromosomally mediated tetracycline resistance is also common among NG isolates in developing world settings , and spectinomycin resistance has (...) begun to appear in some industrialized regions as well . Fluoroquinolone-resistant NG, which first appeared in 1992, is most prevalent in the Far East but occurs throughout the world, including the UK, US, and Canada . Antibiotic resistance in Haemophilus ducreyi , the causative agent of chancroid, continues to spread globally : resistance to trimethoprim/ sulphonamide combination drugs is now widespread in Southeast Asia (e.g. Thailand, Viet Nam, Laos, Cambodia) . The development of highly

2006 CPG Infobase

1952. Canadian Society of Transplantation consensus guidelines on eligibility for kidney transplantation Full Text available with Trip Pro

function (Grade A). Peritonitis, tunnel infections and vascular access-related infections in patients on peritoneal or hemodialysis should be fully treated before transplantation. There are no data to recommend an optimum infection-free interval before transplantation, but documentation of the eradication of infection after completion of antibiotic therapy is appropriate (Grade C). Transplant candidates should be screened for exposure to mycobacteria with a careful clinical history, chest radiography (...) and kidney transplantation (Grade C). Retransplantation should be considered in otherwise eligible patients who have experienced prior renal allograft loss due to polyomavirus-associated nephropathy. The role of transplant nephrectomy and monitoring of urine or plasma BK viral load before transplant remain unclear (Grade B). Patients with sepsis, including active tuberculosis, parasitic or viral disease should be excluded from transplantation until the infection is fully resolved and antimicrobial

2005 CPG Infobase

1953. Prevention of influenza in the general population Full Text available with Trip Pro

yearly and because reinfections occur throughout the lifespan and affect up to 20% of the population each year, considerable attention has been directed to the prevention of infection in healthy people. The rationale for prevention in healthy adults has been to avoid economic loss associated with lost work days and health care provider visits, to decrease antibiotic use and to prevent complications. Previously healthy young children are increasingly recognized as having hospital admission rates (...) of influenza decreases the adverse consequences of infection, there is no direct evidence from randomized controlled trials that immunization of healthy adults and children decreases the risk of secondary complications from influenza (e.g., bacterial pneumonia), hospital admission rates in the winter season, secondary spread of influenza to people at high risk for complications (e.g., hospital admission because of respiratory disease, congestive heart failure and death) or antibiotic use for respiratory

2004 CPG Infobase

1954. Cough in children: definitions and clinical evaluation. Position statement of the Thoracic Society of Australia and New Zealand

be cognisant that a dry cough may become wet if airway secretions increase. Further, it should not be assumed that airway secretions are absent in children with dry cough; therefore, cough quality in these children should be reviewed regularly. Protracted bronchitis Based on preliminary findings, we propose a clinical definition of “protracted bronchitis” as: the presence of isolated chronic moist cough; resolution of cough with appropriate antibiotics; and absence of pointers suggestive of alternative (...) specific cough. In a study using a standardised protocol to evaluate children with chronic cough, protracted bronchitis was the most common (40%) aetiology. When a wet cough only partially resolves after appropriate antibiotics, is very prolonged (more than 3 months) or there are recurrent (more than two per year) episodes of protracted bronchitis, the child requires additional treatment and investigations along the lines of that for chronic suppurative lung disease. Whether this represents a spectrum

2006 MJA Clinical Guidelines

1956. Guideline for the screening and treatment of Retinopathy of Prematurity (ROP)

to ask any questions. What will happen after the treatment? After treatment your baby may need to be given some antibiotic and steroid eye drops to prevent infection and reduce swelling. An appointment will be made for an eye examination about a week later when the ophthalmologist will check if the treatment has stopped the abnormal blood vessels developing. In most babies one treatment is effective but sometimes a second treatment will be needed around 2 to 3 weeks later. Are there any side-effects

2008 Royal College of Paediatrics and Child Health

1957. Management of bronchiectasis and chronic suppurative lung disease in Indigenous children and adults from rural and remote Australian communities Full Text available with Trip Pro

Management Although there is no definitive evidence to support an early treatment approach, it is generally accepted that patients who have CSLD and are thus at risk of bronchiectasis will benefit from early treatment. A longitudinal study has shown that patients with delayed diagnosis have poorer lung function than patients receiving regular antibiotics and physiotherapy. Antibiotics We recommend treating severe or persistent exacerbations of bronchiectasis with intravenous antibiotics and physiotherapy (...) in hospital. Short antibiotic courses of 10–14 days reduce symptoms and levels of inflammatory markers and improve quality of life. In contrast, maintaining antibiotic treatment for as long as 12 months confers only a small benefit. Nonetheless, prolonged courses of macrolide antibiotics are being used. Azithromycin treatment for 6–36 months in patients with CF initially improves lung function and quality-of-life scores while reducing exacerbation frequency. However, these benefits are not sustained

2008 MJA Clinical Guidelines

1958. The Acutely or Critically Sick or Injured Child in the District General Hospital

in distinguishing medical causes of abdominal pain (eg urinary infection and basal pneumonia) from surgical (eg appendicitis). • Early appendicitis may be treated with analgesia, antibiotics and a scheduled operation. • Appendix abscess (non-obstructed) requires initial conservative treatment and referral to the general paediatric surgical service for a possible elective operation. • If appendicitis is diagnosed out of hours, a clinical decision will be made as to whether the patient needs an urgent operation

2006 Royal College of Anaesthetists

1960. Consensus recommendations for the diagnosis, treatment and control of Mycobacterium ulcerans infection (Bairnsdale or Buruli ulcer) in Victoria, Australia Full Text available with Trip Pro

is possible, and there is increasing interest in this approach in western Africa. , However, in Victoria, where there is ready access to surgery, we believe that surgery or combined surgical and medical therapy is the most efficient way of effecting cure. The trend in management is towards conservative surgery with macroscopic removal of necrotic tissue and the use of adjuvant antibiotics. Patients may be best managed by a team, with surgeons working with infectious diseases specialists, GPs and allied (...) health practitioners. For difficult or recurrent disease or when antibiotics and surgery are failing, other modes of therapy, including continuous heat therapy or hyperbaric oxygen, may be considered. Surgery In most situations, we recommend surgery that aims to remove all necrotic tissue, but preserves any involved deep structures (eg, tendons, nerves, joint capsules, major blood vessels). If bone is involved, it should be conservatively debrided. Where possible, remove a small buffer of normal

2007 MJA Clinical Guidelines


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