mercredi 20 janvier 2016

A major paper that requires major changes in everyday practice of medicine

http://annals.org/article.aspx?articleid=2481815

High-Value Care Advice 1Clinicians should not perform testing or initiate antibiotic therapy in patients with bronchitis unless pneumonia is suspected.
High-Value Care Advice 2Clinicians should test patients with symptoms suggestive of group A streptococcal pharyngitis (for example, persistent fevers, anterior cervical adenitis, and tonsillopharyngeal exudates or other appropriate combination of symptoms) by rapid antigen detection test and/or culture for group A Streptococcus. Clinicians should treat patients with antibiotics only if they have confirmed streptococcal pharyngitis.
High-Value Care Advice 3Clinicians should reserve antibiotic treatment for acute rhinosinusitis for patients with persistent symptoms for more than 10 days, onset of severe symptoms or signs of high fever (>39 °C) and purulent nasal discharge or facial pain lasting for at least 3 consecutive days, or onset of worsening symptoms following a typical viral illness that lasted 5 days that was initially improving (double sickening).
High-Value Care Advice 4Clinicians should not prescribe antibiotics for patients with the common cold.

http://www.medpagetoday.com/PrimaryCare/GeneralPrimaryCare/55714?xid=nl_mpt_DHE_2016-01-19&eun=g432148d0r


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