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1961. Orthogeriatric Care

agents are contraindicated, mechanical devices should be used [39]. In addition, it is highly recommended that patients wear pressure gradient stockings as soon as possible after admission. 5.4.6 Prophylactic antibiotics A number of studies have shown the benefit of prophylactic intravenous antibiotics which should be given at the time of induction for surgery and continued for a total of 24 hours post-operatively [40]. Currently, there no proven benefit of topical antibiotic use for prophylaxis (...) . Cochrane Database Syst Rev 2002; (4). 38. PEP Investigators. Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin: Pulmonary Embolism Prevention (PEP) trial. Lancet 2000: 355: 1295-1302. 39. CD000305 Imperiale, T.F. & Speroff, T. A metanalysis of methods to prevent venous thromboembolism following hip replacement. Journal of the American Medical Association, 1994: 271, 1780-5. 40. Southwell-Keely JP. Russo RR. March L. Cumming R. Cameron I. Brnabic AJ. Antibiotic prophylaxis

2004 Australian and New Zealand Society for Geriatric Medicine

1962. Retinopathy of Prematurity Guideline

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 from the treatment? ROP treatment is a surgical

2008 Royal College of Ophthalmologists

1964. Improving outcomes in urological cancers

co-exist with it. 4,7 Cancer is very unlikely to be the cause of such symptoms in younger men or women, but persistent problems that fail to respond to antibiotics are occasionally due to bladder cancer. Haematuria, or blood in the urine, is the most common symptom of both bladder and kidney cancer. Around one patient in five who develops visible haematuria is likely to have urological – usually bladder – cancer. 8,9 Whilst population studies suggest that 11 7 Chamberlain J, Melia J, Moss S, et

2002 National Institute for Health and Clinical Excellence - Clinical Guidelines

1965. The management of secondary lymphoedema - a guide for health professionals

issues: Cellulitis People with lymphoedema are prone to recurrent episodes of cellulitis. Urgent antibiotic treatment is essential to control the spread of infection • dicloxacillin/fl ucloxacillin 500mg orally q6h for 7–10 days or • clindamycin 450 mg orally q8h for patients allergic to penicillin). Refer to antibiotic guidelines 3 . Patient should be advised to: • rest in bed and elevate the aff ected limb/body part • continue use of compression garment if comfortable and tolerable • cease (...) a National Standard for Measurement of Lymphoedematous Limb, 2004 3. Therapeutic Guidelines: Antibiotic, 2006. Version 13:274-277The management of secondary lymphoedema ASSESSMENT • cancer treatment - surgery - lymph node removal - radiotherapy - complications (e.g. post-operative infection) If NO swelling detected, initiate ‘at risk’ education and/or review patient education about: • early warning signs that may appear months or years before onset of swelling: - transient swelling - feelings

2008 Cancer Australia

1967. Therapies for essential tremor

to 750 mg/day use did not result in significant tremor reduction. Another class IV, open-label study found that acetazolamide (in doses up to 500 mg/day) reduced tremor severity, but did not improve patient self-assessment or motor task scale. Isoniazid (Laniazid, Nydrazid). Isoniazid is an antibacterial agent that is used to treat tuberculosis. One class II study randomized 11 patients with ET to isoniazid (doses up to 1,200 mg/day) or placebo over a 4-week period. Only 2 of 11 patients had

2005 American Academy of Neurology

1968. Treatment and recommendations for homeless people with with Otitis Media

/ behavior – Inquire about child’s interaction with family members and behavior at daycare/school. Explore possible causes of behavior problems besides hearing loss (stress, feeling ostracized, family violence). • Missed school – Ask about missed school days due to ear discomfort or other illness. • Prior ear infections/ treatment – Ask about number and treatment of past ear infections, symptoms and duration of current complaint, and whether child has received full course of any antibiotic treatments (...) , transportation, geographical, limited time off from work, behavioral health problems, family stressors). Assist in resolution of identified barriers and weigh these factors in deciding whether to “wait and observe” or prescribe antibiotics for AOM in a homeless child. Assess parent/caregiver’s ability and resources to participate in the plan of care. • Risks of delayed/ interrupted treatment – Explain risks to hearing, speech, emotional development, school performance from chronic, serious ear infections

2008 National Health Care for the Homeless Council

1969. Treatment and recommendations for homeless people with asthma

members or shelter residents to sell on the street or to enhance cocaine effects. Associated problems, complications • Antibiotic use – Recognize possible increased risk of asthma for infants treated with antibiotics; assure antibiotic treatment is warranted. • Financial barriers – Lack of health coverage can present barrier to treatment; provide assistance with Medicaid/ SCHIP applications. Use pharmaceutical discount programs, manufacturer-sponsored patient assistance programs, and gift cards

2008 National Health Care for the Homeless Council

1970. Clinical Guideline on the Treatment of Carpal Tunnel Syndrome

carpal tunnel release: skin nerve preservation (Grade B, Level I) epineurotomy (Grade C, Level II) The following procedures carry no recommendation for or against use: flexor retinaculum lengthening, internal neurolysis, tenosynovectomy, ulnar bursa preservation (Inconclusive, Level II and V). Recommendation 7 The physician has the option of prescribing pre-operative antibiotics for carpal tunnel surgery. (Grade C, Level III) vi Recommendation 8 We suggest that the wrist not be immobilized (...) as the outcome measures at 8 weeks, also had too little power to allow for meaningful statistical comparisons. The study was therefore inconclusive. See Evidence Tables 23-37 and Evidence Report pages 88-95, figures 82-88. 9,15 18 RECOMMENDATION 7 The physician has the option of prescribing pre-operative antibiotics for carpal tunnel surgery. (Grade C, Level III) Rationale Our searches indicated that the current literature rarely reports whether pre-operative antibiotic treatment was used in carpal tunnel

2008 Congress of Neurological Surgeons

1971. Meningococcal septicaemia

management of ABCs as necessary en route. RISK OF INFECTION TO AMBULANCE PERSONNEL Meningococcal bacteria are very fragile and do not survive outside the nose and throat. Public health guidelines recommend preventative antibiotics only for health workers whose mouth or nose is directly exposed to large particle droplets / secretions from the respiratory tract of a patient with meningococcal disease. This type of exposure is unlikely to occur unless Ambulance Clinicians are in close proximity to patients (...) , for example, when undertaking airway management or inhaling droplets when patients cough or sneeze. When a case of meningococcal disease is con?rmed, the public health Doctor will ensure that antibiotics are offered to any contacts of the case whose exposure puts them at increased risk of infection. Key Points – Meningococcal septicaemia ? Meningococcal disease is the leading infectious cause of death in children and young adults and can kill a healthy person of any age within hours of their ?rst symptoms

2006 Joint Royal Colleges Ambulance Liaison Committee

1972. Chronic obstructive pulmonary disease (COPD)

that a patient is in ambulance care hypoxia presents a much greater risk than hypercapnia in most cases. Whilst blood gas levels are important to continuing long term care of the patient, a lack of oxygen will prove fatal far more rapidly in the acute setting than changes in CO2 levels which alter more slowly. Use of systemic corticosteroids as advocated in asthma is of no proven bene?t in acute exacerbations of COPD. A course of oral steroids and/or antibiotics may be appropriate based on the judgement

2006 Joint Royal Colleges Ambulance Liaison Committee

1973. Benzylpenicillin (Penicillin g)

Benzylpenicillin (Penicillin g) Benzylpenicillin (Penicillin G) BPN Drugs October 2006 Page 1 of 2 Drugs PRESENTATION Ampoule containing 600 milligrams of benzylpenicillin as powder. ACTIONS Antibiotic active against a range of bacteria. DOSAGE AND ADMINISTRATION Administer en-route to hospital (unless already administered by GP etc). Administer by slow IV injection. If it is not possible to gain rapid vascular access, the drug should be given by the IM route, as detailed below, into the antero (...) VOLUME <1 year 300 milligrams 5.0ml 1-<9 years 600 milligrams 10.0ml 9 years – adult 1.2 grams (2 vials) 20.0ml Concentration – 600 milligrams dissolved in 9.6ml water for injections. AGE DOSE VOLUME <1 year 300 milligrams 1.0ml 1-<9 years 600 milligrams 2.0ml 9 years – adult 1.2 grams (2 vials) 4.0ml Concentration – 600 milligrams dissolved in 1.6ml water for injections.ADDITIONAL INFORMATION Penicillin Allergy Antibiotic allergy – This will be a very dif?cult judgement for ambulance staff as many

2006 Joint Royal Colleges Ambulance Liaison Committee

1974. Management of bacterial vaginosis

)(11), but it is unclear whether this is a problem in UK practice where many units administer perioperative antibiotics. There are no studies investigating the possible role of BV in the onset of PID following insertion of an intrauterine contraceptive device (IUCD). In one study BV was associated with NGU in male partners(12). Diagnosis Two approaches are available • Amsel criteria(13).At least three of the four criteria are present for the diagnosis to be confirmed. (1) Thin, white, homogeneous (...) to recommend routine treatment of asymptomatic pregnant women who attend a G-U clinic and are found to have BV. • Metronidazole enters breast milk and may affect its taste. The manufacturers recommend avoiding high doses if breast feeding. Small amounts of clindamycin enter breast milk. It is prudent therefore to use an intravaginal treatment for lactating women (C). Termination of pregnancy (TOP) Three studies have investigated whether antibiotics can reduce the rate of infectious morbidity in women

2006 British Association for Sexual Health and HIV

1975. Management of PID

page 2 Signs • lower abdominal tenderness which is usually bilateral • adnexal tenderness on bimanual vaginal examination • cervical motion tenderness on bimanual vaginal examination • fever (>38°C) Complications • Women with HIV may have more severe symptoms associated with PID but respond well to standard antibiotic therapy 6 . No change in treatment recommendations compared to HIV uninfected patients is required 7-9 . (Grade B [III]) • The Fitz-Hugh-Curtis syndrome comprises right upper quadrant (...) of definitive diagnostic criteria, a low threshold for empiric treatment of PID is recommended. Broad spectrum antibiotic therapy is required to cover pid_v4_0205 page 4 N. gonorrhoeae, C. trachomatis and a variety of aerobic and anaerobic bacteria commonly isolated from the upper genital tract in women with PID 1;2;5 . The best evidence for the effectiveness of antibiotic treatment in preventing the long term complications of PID comes from the PEACH study where women were treated with cefoxitin followed

2005 British Association for Sexual Health and HIV

1976. Management of gonorrhoea in adults

available, specific, sensitive and cheap diagnostic test that readily allows confirmatory identification and antimicrobial susceptibility testing. It is currently the method of first choice for use in genitourinary medicine clinics in the UK. Selective culture media containing antimicrobials are recommended to reduce contamination 5 (recommendation level B). • Alternative tests include nucleic amplification tests (NAATs) and nucleic acid hybridization tests. NAATs are more sensitive than culture and can (...) is lacking on the sensitivity of a single set of tests from anogenital sites to identify infection with N. gonorrhoeae. To confidently exclude infection in patients who attend within three days of sexual contact with a confirmed case of gonorrhoea, a second set of tests should be considered if epidemiological treatment with effective antimicrobial therapy is not given 12 (evidence level IV, recommendation level C). Management. General Advice. • Referral to a GU Medicine Department for management

2005 British Association for Sexual Health and HIV

1977. UK National STI Screening and Testing Guideline

-specific (poor positive predictive value – 17%). Because of the serious long term sequelae of PID and the low risk associated with antibiotic use, a low threshold for making a clinical diagnosis of PID is appropriate i.e. any sexually active woman with lower abdominal pain plus either adnexal tenderness or cervical motion tenderness. Window Period The minimum time gap between exposure to a sexually transmitted infection and its successful detection will vary depending on a number of factors, including (...) : 13• the organism • the size of inoculum • the type of test utilised The evidence base for specific recommendations on how long to wait before testing for different STIs is limited. In general: • for serological testing (e.g. HIV, syphilis, hepatitis), an interval of 3-6 months is required with the interval reflecting the timing of potential exposure to infection (level IIb) • for bacterial STIs, many clinicians would wait 3-7 days before testing (level IV) Recent Antibiotic Use Patients taking

2006 British Association for Sexual Health and HIV

1978. Consensus guidelines for dosing of amoxicillin-clavulanate in melioidosis Full Text available with Trip Pro

exposure to Burkholderia pseudomallei—Los Angeles, California, 2003. MMWR Morb Mortal Wkly Rep 53 : 988 –990. Gilbert D, Moellering R, Eliopolous G, Sande M, 2006 . The Sanford Guide to Antimicrobial Therapy 2006. Sperryville, VA: Antimicrobial Therapy. Arzola JM, Hawley JS, Oakman C, Mora RV, 2007 . A case of prostatitis due to Burkholderia pseudomallei. Nat Clin Pract Urol 4 : 111 –114. Lee YL, Lee SS, Tsai HC, Chen YS, Wann SR, Kao CH, Liu YC, 2006 . Pyogenic liver abscess caused by Burkholderia

2008 Clinical Practice Guidelines Portal

1979. Diagnostic and therapeutic approach to persistent or recurrent fevers of unknown origin in adult stem cell transplantation and haematological malignancy

to share full-text version of article. I have read and accept the Wiley Online Library Terms and Conditions of Use. Shareable Link Use the link below to share a full-text version of this article with your friends and colleagues. Copy URL Share a link - Based on these observations, two prospective, randomised controlled‐trials (RCT) were performed to compare the efficacy of AmB‐D versus continuing antibiotics alone and/or discontinuing all antimicrobial therapy for the treatment of PFUO. , In both (...) of administering AmB‐D empirically to treat possible IFI in patients who develop PFUO while receiving broad‐spectrum antibiotics, as the standard of care. Empirical antifungal therapy trials and newer antifungal agents AmB‐D was the first agent used as empirical antifungal therapy (EAFT). Many experts attribute the lack of overall survival advantage observed with AmB‐D, when used as EAFT, to its well‐known toxicities. Several RCTs have since explored the efficacy and safety of newer but more expensive agents

2008 Clinical Practice Guidelines Portal

1980. Guidelines for the prevention of sepsis in asplenic and hyposplenic patients (Abstract)

Guidelines for the prevention of sepsis in asplenic and hyposplenic patients Asplenic or hyposplenic patients are at risk of fulminant sepsis. This entity has a mortality of up to 50%. The spectrum of causative organisms is evolving as are recommended preventive strategies, which include education, prophylactic and standby antibiotics, preventive immunizations, optimal antimalarial advice when visiting endemic countries and early management of animal bites. However, there is evidence

2008 Clinical Practice Guidelines Portal


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