Resources added in May


Practical Evidence About Real Life Situations PEARLS are brief (minimalistic summaries) of Cochrane Primary care systematic reviews with the answer in the title (so you only read the ones you like). Some PEARLS have become accessible that were not available last year.

Access all PEARLS here
562 Standardised packaging reduces tobacco use
561 No effective interventions for molluscum contagiosum
560 Topical analgesics effective for acute and chronic pain
559 Shared care effective for depression
558 Psychosocial interventions effective for smoking cessation in pregnancy
557 Industry sponsorship influences research outcomes
556 Breastfeeding support improves outcomes
555 Limited evidence for benefits of prophylactic drug treatment for febrile seizures
554 Moisturisers beneficial for eczema
553 Non-medical prescribers effective in management of chronic disease
552 Topical capsaicin effective for chronic neuropathic pain
551 Topical analgesics effective for acute and chronic pain
550 Psychosocial therapy of some benefit in recurrent abdominal pain in childhood

Goodfellow Gems

Goodfellow Gems are chosen by the Goodfellow director Dr Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice. ©The Goodfellow Unit. Here is the latest example.

Highlights from 2017 BPAC antibiotic guide
Shorter courses of antibiotics, more intensive dosing regimens and reserving broader spectrum antibiotics for specific scenarios.

Sinusitis: Most cases are not bacterial - consider inhaled nasal steroid.2 Consider antibiotics when symptoms that persist for more than ten days, severe symptoms or fever (>39 °C) and purulent nasal discharge or facial pain lasting for at least three consecutive days, or onset of worsening symptoms after initial improvement. Amoxil first line.
Impetigo: antiseptics first line (hydrogen peroxide 1% cream or povidone-iodine 10% ointment for 5 days. Topical antibiotics are strongly discouraged. Oral antibiotics second line or for widespread infection.
Cellulitis now shorter at 5 days with flucloxacillin 500 mg QID. Amoxicillin clavulanate first line for diabetic foot infections and human/animal bite if infected.
Diverticulitis: mild cases don’t need antibiotics; if needed then trimethoprim + sulfamethoxazole 960 mg, twice daily, with metronidazole, 400 mg, three times daily, for five days.
references online