Who's Giving Inappropriate Antibiotics - Urgent Care, Retail, Emergency, or Medical Office?

Who's Giving Inappropriate Antibiotics - Urgent Care, Retail, Emergency, or Medical Office?

Urgent care centers wrote the most inappropriate antibiotic prescriptions for viral respiratory illnesses.  They were followed by the ED, medical offices, and finally by retail health clinics.

Acetaminophen 3rd Trimester and Ductal Closure

Acetaminophen 3rd Trimester and Ductal Closure

Acetaminophen use during late pregnancy was associated with premature ductus arteriosus closure in these two cases.

Better Medical Miscarriage Treatment

Better Medical Miscarriage Treatment

In women with confirmed first trimester pregnancy loss, the combination of mifepristone 200mg orally and misoprostol 800μg vaginally at 24 hours vs misoprostol 800μg alone resulted in improved complete expulsion at day 8 (NNT = 6) and decreased need for surgery: 9% vs 24%.

Predicting Outpatient Failure for Cellulitis

Predicting Outpatient Failure for Cellulitis

Tachypnea, chronic ulcers, prior MRSA colonization, and prior cellulitis in the past 12 months were all associated with an increased risk of oral antibiotic failure for treatment of non-purulent cellulitis.

Stop Anticoagulants for Nuisance Bleeding?

Stop Anticoagulants for Nuisance Bleeding?

Nuisance bleeding in patients with atrial fibrillation on oral anticoagulants did not portend subsequent major bleeding or increased risk for stroke/systemic embolism.

Influenza Kills - A Sobering Reminder

Influenza Kills - A Sobering Reminder

Influenza killed 675 children from the 2010-11 flu season to the 2015-16 season.  Infants under 6 months had the highest incidence of mortality.  Encourage everyone to get vaccinated.  Antiviral treatment is encouraged in all children under 2, all patients with severe illness, and all hospitalized patients regardless of whether or not the duration of illness exceeds 48 hours.

Opioids Not Better Than Non-Opioids for Back, Hip, Knee Pain

Opioids Not Better Than Non-Opioids for Back, Hip, Knee Pain

Opioids were no better than non-opioid medicines for chronic back, hip, or knee pain. However, undesirable medication-related symptoms occurred more commonly among those taking opioids. 

Value of "Red Flag" Questions for Back Pain

Value of "Red Flag" Questions for Back Pain

Positive responses to "red flag" screening questions for back pain warranted further investigation, though the positive predictive value was poor.  Negative responses to screening "red flag" questions were useless as a screening tool for ruling out serious disease, such as fracture, infection, malignancy, or cauda equina.

Self-Reduction of Shoulder Dislocation - Like a Boss

Self-Reduction of Shoulder Dislocation - Like a Boss

The Boss-Holzach-Matter (aka Davos, self-reduction) technique was less painful than the physician-driven Spaso technique and just as successful and efficient.

Fluoroquinolones - Risk of Aortic Aneurysm and Dissection

Fluoroquinolones - Risk of Aortic Aneurysm and Dissection

Fluoroquinolone use was associated with increased risk of developing newly diagnosed aortic aneurysm or dissection.

MRSA - I&D Only or Add Antibiotics?

MRSA - I&D Only or Add Antibiotics?

This meta-analysis of 4 RCTs found anti-MRSA antibiotics in addition to I&D led to a far better cure rate than I&D alone.

Does Diphenhydramine Help EPS with Prochlorperazine?

Does Diphenhydramine Help EPS with Prochlorperazine?

Prophylactic diphenhydramine reduces extrapyramidal symptoms in patients receiving bolus anti-emetic therapy (given over 2 minutes), but not when the anti-emetic is given as an infusion over 15 minutes.

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