Category General Practice
Pertussis questions from one of our general practitioners
An 8 year old child with a history of cough for 2 weeks +. The GP tested the child by throat swab and PCR which was positive. A 7 day course of erythromycin was prescribed. Reviewed then and patient complaining that the cough worsening. Q & A : The cough is worsening – does he […]
What is the best way to treat skin abscess?
Skin (staphylococcal) abscesses (boils) are often treated with antimicrobials, but are they really needed? The New England Journal of Medicine recently presented a case vignette and asked prescribers to weigh in on whether they thought antibiotics were needed or if incision and drainage alone were enough.
Cranberry for prevention and treatment of UTI- placebo or better?
Updated 25/1/24: Cochrane review was updated in Dec 2023 . “Authors’ conclusions: After a thorough search, no RCTs which assessed the effectiveness of cranberry juice for the treatment of UTIs were found. Therefore, at the present time, there is no good quality evidence to suggest that it is effective for the treatment of UTIs. ” Cranberry […]
More Choosing Wisely recommendations released today
Choosing Wisely Australia is an organisation that aims to improve the quality of healthcare provided to Australians by urging healthcare providers to reconsider tests, procedures or treatments where the evidence suggests no benefit or may lead to harm in some cases. Today the organisation released 50 new recommendations from 12 new Australian professional bodies to […]
Oral antibiotics for paronychia: unexpected outcomes of ‘killing a fly with a cannon’
The recommended treatment for mild paronychia is conservative. Warm compresses or soaks are used, along with topical antibiotics with or without topical steroids. If an abscess has formed around the nail, incision and drainage is added. Oral antibiotics are only recommended in refractory cases or in patients with comorbidities such as diabetes or immunosuppression. We […]
Antibiotics and the QT Interval
Guest post : Ian Whyte, Professor of Clinical Pharmacology at Calvary Mater Newcastle and University of Newcastle Case report (Knorr et al 2008 Ciprofloxacin-induced Q-T interval prolongation) 16-year-old boy was admitted for the treatment of an acute flare of Crohn’s disease and a perirectal abscess. The patient was started on ciprofloxacin 400 mg IV twice daily […]
Let’s stop using antibiotics for uncomplicated diverticulitis
Guest posting : Dr Daniel Isacson, local GP (ex Swedish researcher) The evidence is out and there is no proven benefit in recovery or complication rates in treating these patients with or without antibiotics, but still many GPs and surgeons prefer to use antibiotics. How do we get the word across?
The art of antibiotic prescribing in general practice
Guest posting from Dr Gillian Deakin, General Practitioner and author of 101 Things Your GP Would Tell You If Only There Was Time. Beyond the usual medical challenges of appropriate prescribing, GPs also need skills to ensure that the patient accepts the treatment. Unlike the hospital patient where the patient is largely obliged to accept […]
Trap – cellulitis or an acute Charcot’s foot ?
Updated 25/1/24 – C-reactive protein entry changed – CRP may not be normal An acute Charcot process within a neuropathic foot (often a diabetic patient) arises silently over some months and is often misdiagnosed as cellulitis due to the presence of skin warmth and redness. The process is usually unilateral.
AIMED - Let's talk about antibiotics 