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NIHR Signal Prescribing anti-inflammatories for urine infection reduces antibiotic use but increases complication risk
Urinary tract infection symptoms resolved by three days for 80% of women given antibiotics compared with 54% given anti-inflammatories. Anti-inflammatories reduced antibiotic use, but 5% of women developed more severe infection of the kidneys. Urinary infections are the second most common reason for prescribing antibiotics in general practice, after respiratory infection. As such, this use may be contributing to increasing antibiotic resistance. This Swiss trial provided an important head-to-h...
NIHR Signal Vaccination likely to reduce influenza in healthy children
In healthy children aged two to 16, vaccines are likely to reduce laboratory-confirmed cases of influenza and may reduce the risk of influenza-like illness compared to placebo. Seven children need to receive the live vaccine to prevent one case of confirmed influenza. Twenty children need to be vaccinated to prevent one case of influenza-like illness. This updated Cochrane review included 41 trials of either live attenuated (weakened) or inactivated influenza vaccines, with over 200,000 partici...
NIHR Signal Probiotics can prevent bacterial diarrhoea in hospital patients receiving antibiotics
Giving probiotics to people taking antibiotics reduces the chance of them developing diarrhoea caused by Clostridium difficile (C. difficile) bacteria by 60%. One case of Clostridium-associated diarrhoea was prevented for every 42 people receiving probiotics. They appear to work best for patients at more than 5% risk of Clostridium infection. When antibiotics disturb healthy gut bacteria, Clostridium bacteria may multiply to toxic levels, causing diarrhoea and serious intestinal complications. ...
NIHR Signal Sending patient reminders improves immunisation uptake
Contacting patients by telephone or mail about recommended immunisations leads to eight more people in every 100 being immunised. Text messages, postcards or automatic dialling techniques and recorded voices are the reminder methods that have the highest certainty of being effective. In the UK over 90% of children currently receive the recommended immunisation programme, but this is still below optimal to prevent infection. The uptake of the influenza vaccination in over 65s is also below natio...
NIHR Signal Adding the extra antibiotic rifampicin did not improve cure rates after sepsis
Adding the antibiotic rifampicin did not improve cure rates or reduce deaths for people with bacterial blood infections caused by Staphylococcus aureus. It increased the risk of adverse reactions requiring a change in treatment and the chances of drug interactions. This NIHR-funded trial is the largest to date on adding rifampicin to standard antibiotic therapy. The study included 770 people in 29 UK hospitals. Half were assigned to 14 days of treatment with rifampicin on top of their existing ...
NIHR Signal Swimming in seawater is linked with an increased chance of some illnesses
People who swim in seawater have almost double the odds of experiencingillness than people who avoid it. The specific illnesses linked to seawater exposure are ear and gastrointestinal illnesses, but the exact or absolute rates of infection are not available. Many people enjoy coastal waters for sport and recreation, and it's important that they can access relevant risk information. This is the first systematic review to look at infection risk from swimming in seawater. It gathered data fro...
NIHR Signal A third of health practitioners do not get vaccinated against flu
Flu vaccination uptake amongst healthcare workers in England is below the NHS target of 75%. Reasons may include mixed views on the vaccine’s effectiveness, side effects and belief they are unlikely to catch or transmit flu. Surprisingly, practical barriers such as time and access to vaccination were not mentioned in this systematic review of qualitative studies for the Department of Health. Though it included mainly North American studies, the findings are consistent with issues raised i...
NIHR Signal Intravenous antibiotics, administered over 3 hours, are linked to lower death rates in sepsis
The risk of death in adults with sepsis was 30% lower when each dose of antibiotic was given intravenously over three hours compared to a bolus or less than 60 minutes. This systematic review included adults on intensive care units with a range of ages, severity of sepsis and other symptoms. A variety of antibiotics of the anti-pseudomonal beta-lactam class were used in the trials. These included carbapenems, penicillins and cephalosporins. In the UK, current guidance for intravenous use of th...
NIHR Signal Social exclusion heightens risk of death across many health conditions
Socially excluded men have a mortality rate that is nearly eight times higher than the average for other men, and it is almost 12 times higher for excluded women. These health inequities in outcomes exist across a wide range of health conditions, particularly in infectious diseases and mental health. These findings suggest the need for a joined-up approach across sectors to support inclusive services and policies. Populations who experience social exclusion included in the NIHR-supported study ...
NIHR Signal Biological therapies for psoriasis do not increase serious infection risk
People with psoriasis who take an immune-modulating treatment are no more likely to get serious infections than people taking standard therapies. There are fears that these biological therapies raise the risk of serious infections and this has discouraged their use. They are recommended by NICE for moderate to severe psoriasis. Previous studies have reached conflicting conclusions, making it hard to advise on the true risk. This study used a large database of people with psoriasis from the UK ...
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