Angioedema – Icatibant Rant
Icatibant did not improve outcome compared to placebo for ACE-I associated angioedema.
Nebulized Hot Salts – What Could Possibly Go Wrong?
Hypertonic saline nebulized treatments did not reduce hospitalization in children with bronchiolitis in this large RCT.
Antibiotics as Weapons of Mass Destruction
Adverse effects from antibiotics are very common, up to 20% of the time in hospitalized patients. Only use them when needed.
Weird Sepsis Cocktail – Vitamin C, Thiamine, Hydrocortisone
A cocktail of IV vitamin C, hydrocortisone, and thiamine appeared to dramatically reduce mortality in this small, exploratory, before/after study.
Anaphylaxis Prophylaxis
It makes sense to treat an allergic reaction with an antihistamine. This study suggests that treating patients with an allergic reaction with a H1-antagonist may decrease the chance of disease progression to anaphylaxis, though the level of evidence is weak.
Do We Need Cephalexin Plus TMP-SMX?
For uncomplicated cellulitis in otherwise healthy patients, cephalexin alone is probably adequate.
Loperamide Abuse – Watch for Conduction System Abnormalities
Loperamide abuse is increasingly seen. It can be rarely associated with cardiac conduction system disturbances. Talk to poison control, and put these patients on a monitor.
Urticaria- Hold the Prednisone
Prednisone 40mg daily x 4 days was not helpful in reducing itching in patients with simple urticaria.
Nitrous Oxide and Intranasal Fentanyl for Sedation
Intranasal fentanyl and N2O was a rapid way to perform pediatric sedation with no IV, but more patients cried, grimaced, and kicked during the procedure; and 12% vomited.
Why We Give Dexamethasone for Mild Croup
Dexamethasone is beneficial for mild croup, not just moderate to severe.