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Interventions for ear discharge associated with grommets (ventilation tubes)

More research is needed to find the most effective treatment for discharge from ears in patients who have had grommets fitted.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Antibiotics prior to embryo transfer in ART

In vitro fertilisation (IVF) describes an assisted reproductive technology (ART) during which a woman undergoes ovarian stimulation, surgical retrieval of eggs, fertilisation of eggs outside of the body, and finally the transfer of resulting embryo(s) into the uterus by an embryo transfer (ET) procedure. During an ET, the embryo(s) is passed through the cervix by means of a catheter. Many variables affect the chance of pregnancy after ET, including embryo quality, uterine factors and the embryo transfer technique. High levels of bacteria and other organisms in the upper genital tract have a detrimental effect on pregnancy rate after ET. Administration of antibiotics prior to ET may reduce the growth of these organisms and improve the outcomes of IVF. This review considered the question of whether antibiotics given at any time prior to ET affect pregnancy rates and other important outcomes of IVF.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Antibiotics to treat respiratory infections caused by the bacteria Mycoplasma pneumoniae in children

This review sought to answer the question of whether antibiotics are effective in the treatment of LRTIs caused by the bacteria Mycoplasma pneumoniae (M. pneumoniae) in children.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Antibiotics for preterm rupture of membranes

Certain antibiotics given to women whose waters have broken early will improve babies' health. Babies born too soon are more likely to suffer ill health in the early days and sometimes throughout life. Early labour and birth (before 37 weeks) may be due to undetected infection as well as the waters breaking early. The review of 22 trials, involving 6872 women and their babies, found that, in the short term, certain antibiotics given to women, when their waters break early, increase the time babies stay in the womb. They reduced infection, but did not save more babies. One antibiotic (co‐amoxiclav) increased the number of babies with a rare condition of inflammation of the bowel (necrotising enterocolitis). Although, in the longer term (at seven years of age) antibiotics seem to have little effect on the health of children, the short‐term advantages are such that we recommend antibiotics should be given routinely.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Azithromycin for acute lower respiratory tract infections

We conducted this review to compare azithromycin with amoxycillin or amoxyclav in treating acute lower respiratory tract infections (LRTI).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Minimal Modeling Approaches to Value of Information Analysis for Health Research [Internet]

Value of information (VOI) techniques can provide estimates of the expected benefits from clinical research studies. These VOI estimates can inform decisions about the design and priority of those studies. Most VOI studies use decision analytic models to characterize the uncertainty of the effects of interventions on health outcomes. For some potential applications of VOI, the complexity of constructing such models poses barriers to practical application of VOI. However, because some clinical studies can directly characterize uncertainty in health outcomes, it may sometimes be possible to perform VOI analysis with only minimal modeling. This paper (1) develops a framework to define and classify minimal modeling approaches to VOI; (2) reviews existing VOI studies that apply minimal modeling approaches; and (3) illustrates and discusses the application of the minimal modeling to two new clinical applications to which the approach appears well suited because clinical trials with comprehensive outcomes provide preliminary estimates of the uncertainty in outcomes. We conclude that minimal modeling approaches to VOI can be readily applied to in some instances to develop estimates of the expected benefits of clinical research.

Methods Future Research Needs Reports - Agency for Healthcare Research and Quality (US).

Version: June 2011
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Systemic anti-infective periodontal therapy: a systematic review

BACKGROUND: Periodontal diseases are infections and thus systemically administered antibiotics are often employed as adjuncts for their control. There are conflicting reports as to whether these agents provide a therapeutic benefit.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2003

Management of Acute Otitis Media: Update

Acute Otitis Media (AOM), a viral or bacterial infection of the ear, is the most common childhood infection for which antibiotics are prescribed in the United States. In 2001, the Southern California Evidence-based Practice Center conducted a systematic review of the evidence comparing treatments of AOM.

Evidence Reports/Technology Assessments - Agency for Healthcare Research and Quality (US).

Version: November 2010
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Increased clinical failures when treating acute otitis media with macrolides: a meta-analysis

The review found that paediatric patients with acute otitis media and treated with macrolide antibiotics compared to first-line antibiotics may be more likely to have clinical failures. The authors' conclusions reflect the evidence presented, but limitations in the quality of many of the included studies mean the conclusions should be considered tentative.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Macrolides, quinolones and amoxicillin/clavulanate for chronic bronchitis: a meta-analysis

The comparative effectiveness and safety of macrolides, quinolones and amoxicillin/clavulanate (A/C) for the treatment of patients with acute bacterial exacerbation of chronic bronchitis (ABECB) was evaluated in the present study. PubMed, Current Contents and the Cochrane Central Register of Controlled Trials were searched to identify relevant randomised controlled trials (RCTs). In total, 19 RCTs (20 comparisons) were included in the present analysis. There was no difference regarding treatment success in intention-to-treat and clinically evaluable patients between macrolides and quinolones, A/C and quinolones or A/C and macrolides. The treatment success in microbiologically evaluable patients was lower for macrolides compared with quinolones (odds ratio (OR) 0.47, 95% confidence interval (CI) 0.31-0.69). Fewer quinolone-recipients experienced a recurrence of ABECB after resolution of the initial episode compared with macrolide-recipients during the 26-week period following therapy. Adverse effects in general were similar between macrolides and quinolones. Administration of A/C was associated with more adverse effects (mainly diarrhoea) than quinolones (OR 1.36, 95% CI 1.01-1.85). Macrolides, quinolones and amoxicillin/clavulanate may be considered equivalent for the treatment of patients with an acute bacterial exacerbation of chronic bronchitis in terms of short-term effectiveness. Quinolones are associated with better microbiological success and fewer recurrences of acute bacterial exacerbation of chronic bronchitis than macrolides, while amoxicillin/clavulanate is associated with more adverse effects than both comparators.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Urinary Tract Infection in Children: Diagnosis, Treatment and Long-term Management

In the past 30–50 years, the natural history of urinary tract infection (UTI) in children has changed as a result of the introduction of antibiotics and improvements in health care. This change has contributed to uncertainty about the most appropriate and effective way to diagnose and treat UTI in children and whether or not investigations and follow-up are justified.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: August 2007
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Urinary Incontinence in Neurological Disease: Management of Lower Urinary Tract Dysfunction in Neurological Disease

The guideline covers adults and children (from birth) with lower urinary tract dysfunction resulting from neurological disease or injury.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: August 2012
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Bacterial Meningitis and Meningococcal Septicaemia: Management of Bacterial Meningitis and Meningococcal Septicaemia in Children and Young People Younger than 16 Years in Primary and Secondary Care

This guideline covers bacterial meningitis and meningococcal septicaemia, focusing on management of these conditions in children and young people aged younger than 16 years in primary and secondary care, and using evidence of direct relevance to these age groups where available.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: 2010
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Antibiotics for Early-Onset Neonatal Infection: Antibiotics for the Prevention and Treatment of Early-Onset Neonatal Infection

Early-onset neonatal bacterial infection (infection with onset within 72 hours of birth) is a significant cause of mortality and morbidity in newborn babies. Parent organisations and the scientific literature report that there can be unnecessary delays in recognising and treating sick babies. In addition, concern about the possibility of early-onset neonatal infection is common. This concern is an important influence on the care given to pregnant women and newborn babies. There is wide variation in how the risk of early-onset neonatal infection is managed in healthy babies. The approach taken by the NHS needs to: prioritise the treatment of sick babies, minimise the impact of management pathways on healthy women and babies, use antibiotics wisely to avoid the development of resistance to antibiotics. These drivers have not always been addressed consistently in the NHS, and this guideline was commissioned to ensure they would be addressed in future.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: August 2012
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Feverish Illness in Children: Assessment and Initial Management in Children Younger Than 5 Years

It is a requirement of the Children’s National Service Framework that all ill children should have access to high-quality, cost-effective, evidence-based care. Because it is difficult to evaluate the severity of the illness, there is a need for evidence-based guidance to inform healthcare professionals about how to judge whether a child who presents with a fever is likely to develop a serious illness. Healthcare professionals also need advice to support their decision on whether to observe the child, perform diagnostic tests, start treatment such as antibiotics or refer onwards for specialist care. The guidance should also include advice on the best ways to detect fever, the management of fever itself, and what to tell parents and carers who have made contact with healthcare services. The guidance should be applicable to primary and secondary care and should take account of the number of agencies that are involved in giving health care and giving advice to parents and carers. It is also important that parental preferences, as well as the child’s best interests in terms of health outcomes, should be taken into account when considering the various options for investigation and treatment.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: May 2013
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Caesarean Section

This guidance is a partial update of NICE clinical guideline 13 (published April 2004) and will replace it.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: November 2011
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Dyspepsia and Gastro-Oesophageal Reflux Disease: Investigation and Management of Dyspepsia, Symptoms Suggestive of Gastro-Oesophageal Reflux Disease, or Both

The guideline applies to adults (aged 18 and over) with symptoms suggestive of dyspepsia, symptoms suggestive of gastro-oesophageal reflux disease (GORD), or both.

NICE Clinical Guidelines - Internal Clinical Guidelines Team (UK).

Version: September 2014
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Bismuth Salts for Gastrointestinal Issues: A Review of the Clinical Effectiveness and Guidelines [Internet]

The purpose of this report is to retrieve and review existing evidence of clinical efficacy, safety, and guidelines for bismuth treatment of diarrhea, nausea, indigestion, heartburn, and upset stomach. This report also aims to retrieve and review the existing evidence for the clinical efficacy and safety of bismuth as part of bismuth-containing quadruple therapy (BCQT) in the treatment of H. pylori infection. Finally this report will retrieve and review the existing guidelines on the use of BCQT for H. pylori eradication treatment.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: November 24, 2015
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Ivacaftor (Kalydeco) 150 mg Tablet: For Treatment of Cystic Fibrosis with G551D, G1244E, G1349D, G178R, G551S, S1251N, S1255P, S549N, S549R, or G970R Mutation [Internet]

Cystic fibrosis (CF), an autosomal recessive condition, is the most common fatal genetic disease affecting children and young adults in Canada. It is caused by mutations in the CF transmembrane conductance regulator (CFTR) gene, located on chromosome seven. This gene encodes for a chloride channel that regulates transport of salt and water across cell membranes. When CFTR is dysfunctional, secretions become tenacious and sticky, resulting in pathology in multiple organ systems, most notably the lungs and gastrointestinal tract.

Common Drug Review - Canadian Agency for Drugs and Technologies in Health.

Version: July 2015
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Macitentan (Opsumit): For Long-Term Treatment of Pulmonary Arterial Hypertension [Internet]

Pulmonary arterial hypertension (PAH; also classified as Group 1 pulmonary hypertension [PH]) is a rare, debilitating, progressive, and life-threatening disease of the pulmonary vasculature, characterized by vascular proliferation and remodelling of small pulmonary arteries. PAH is defined by an increase in mean pulmonary arterial pressure (mPAP) ≥ 25 mm Hg and a pulmonary wedge pressure of ≤ 15 mm Hg. If left untreated, it can lead to right heart failure and premature death.

Common Drug Review - Canadian Agency for Drugs and Technologies in Health.

Version: July 2015

Systematic Reviews in PubMed

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