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NIHR Signal Treating asymptomatic MRSA on discharge from hospital reduces risk of later infection
Use of medicated creams, mouthwash and body wash for six months after discharge from hospital led to a 30% lower risk of MRSA infection, compared with basic hygiene education. This study was carried out in the USA using 2,121 adults who had tested positive for MRSA in hospital, but who had no symptoms. Meticillin-resistant Staphylococcus aureus (MRSA) bacteria have developed resistance to widely-used antibiotics. MRSA is easily transferable within healthcare settings, and people may become colo...
NIHR Signal Intravenous magnesium can reduce shivering in patients after surgery
An infusion of magnesium, given during or immediately after surgery, reduces the proportion of patients who experience shivering in the operating theatre or in recovery from 23% to 9.9%. Shivering is unpleasant for the patient and may place strain on the cardiovascular system, as it increases oxygen use. A review of 64 trials found that intravenous magnesium was effective compared to placebo without any reported adverse effects. In the UK, frequent temperature checks and active warming are rou...
NIHR Signal Switching to oral antibiotics early for bone and joint infections gave similar results to continuing intravenous therapy
For adults with bone or joint infection, many of whom had metal implants, beginning six weeks of oral antibiotics within seven days of intravenous treatment, was no worse than a regimen delivered wholly intravenously (IV). After one year, around 14% of both groups still had an infection, showing the difficulty of treatment, irrespective of the route of administration. Although current practice suggests antibiotics should be given IV for bone and joint infections, for at least six weeks, this la...
NIHR Signal When is it best to start the Parkinson’s drug, levodopa?
Earlier treatment with levodopa provides symptomatic relief to those with symptoms but does not appear to slow Parkinson’s disease from progressing. Therefore, timing is best determined by symptoms. The treatment of Parkinson’s disease is complex. Levodopa is the main drug used to reduce tremors and muscle stiffness. Whether it modifies the course of the disease or becomes less effective over time is debated, and it can have side effects, so patients and clinicians sometimes prefer ...
NIHR Signal E-cigarettes helped more smokers quit than nicotine replacement therapy
Smokers who use NHS stop smoking services appear almost twice as likely to be successful for a year if they use e-cigarettes than if they use nicotine replacement therapy (NRT) products. In a trial of 866 smokers who used NHS stop smoking services, 18% of those assigned to e-cigarettes were abstinent 12 months from their quit date, compared to 9.9% of those assigned to NRT. Everyone in the study was also offered four weeks of one-to-one behavioural support from a clinician. Of those who had suc...
NIHR Signal Does an antibacterial milk protein reduce infection in premature babies?
Lactoferrin, a protein found in human and cows milk, does not appear to protect premature infants from late-onset infections. When given to babies born before 32 weeks, their risk of acquiring infections, such as sepsis, was virtually the same as those in the control group, about 30%. Late-onset infections, those occurring 72 hours or more after birth, are a significant cause of illness and even death in newborns. Premature babies are particularly vulnerable. This very large UK based NIHR funde...
NIHR Signal One gram a day of omega-3 supplements does not reduce the risk of cancer or cardiovascular disease
A trial of omega-3 fatty acid supplements showed they have little or no effect on the risk of cancer or cardiovascular disease in the general population. The finding contradicts the widespread belief that these supplements at usual doses protect the heart. A large trial of 25,871 men and women in the United States compared the impact of taking about 1g a day of omega-3 fatty acid supplements with placebo on major cardiovascular events and invasive cancer. The results are consistent with a recen...
NIHR Signal Various drugs are effective and well-tolerated for generalised anxiety disorder
There are various drugs options for the treatment of generalised anxiety disorder, from different medication classes. This study found that most evidence was available for the serotonin and noradrenaline re-uptake inhibitors (SNRI) duloxetine and venlafaxine, the selective serotonin reuptake inhibitor (SSRI) escitalopram, and the anti-epileptic pregabalin. All appear well-tolerated and reduce symptoms compared with placebo. The SSRI sertraline, commonly used in practice, was equally effective an...
NIHR Signal Antimicrobial stewardship programmes reduce antibiotic use in long-term care homes
Antimicrobial stewardship programmes have been found to reduce antibiotic use in long-term care residences by 14% when pooling evidence across a range of study types and interventions. Antimicrobial resistance is a public health threat, and overuse of antimicrobials is one of the main causes. Antimicrobial stewardship programmes are a government strategy to support the appropriate prescribing of antimicrobials within the NHS. There has been little evidence for their use or effectiveness in lon...
NIHR Signal Medication to reduce stomach acid may increase risk of hip fractures
People who take proton pump inhibitors for digestive disorders such as stomach ulcers and acid reflux may be up to 24% more likely to experience hip fractures. Nevertheless, the benefits of treatment in an individual may outweigh this effect unless the risk of osteoporosis or fracture is high. A conversation between the prescriber and the individual patient on relative risks should help in a treatment decision. The link may be important for people taking these drugs, especially if they have ot...
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