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The microbial causes of pneumonia vary according to its origin and the immune constitution of the patient. Pneumonia is classified into community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP) and pneumonia in the immunocompromised. The guideline development process is guided by its scope - published after stakeholder consultation. This guideline does not cover all aspects of pneumonia, but focuses on areas of uncertainty or variable practice and those considered of greatest clinical importance. Best practice guidance on the diagnosis and management of CAP and HAP is offered, based on systematic analysis of clinical and economic evidence with the aim of reducing mortality and morbidity from pneumonia and maximising resources.

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

Version: December 2014

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

The study found that rapid molecular tests for rifampicin and isoniazid resistance resistance in tuberculosis were sensitive and specific, and may be cost-effective when added to culture drug susceptibility testing in the UK.

Health Technology Assessment - NIHR Journals Library.

Version: May 2015

Latent tuberculosis infection (LTBI), defined as a state of persistent immune response to prior-acquired Mycobacterium tuberculosis antigens without evidence of clinically manifested active TB, affects about one-third of the world’s population. Approximately 10% of people with LTBI will develop active TB disease in their lifetime, with the majority developing it within the first five years after initial infection. Currently available treatments have an efficacy ranging from 60% to 90%. Systematic testing and treatment of LTBI in at-risk populations is a critical component of WHO’s eight-point framework adapted from the End TB Strategy to target pre-elimination and, ultimately, elimination in low incidence countries.

World Health Organization.

Version: 2015

Surgical site infections are caused by bacteria that get in through incisions made during surgery. They threaten the lives of millions of patients each year and contribute to the spread of antibiotic resistance. In low- and middle-income countries, 11% of patients who undergo surgery are infected in the process. In Africa, up to 20% of women who have a caesarean section contract a wound infection, compromising their own health and their ability to care for their babies. But surgical site infections are not just a problem for poor countries. In the United States, they contribute to patients spending more than 400 000 extra days in hospital at a cost of an additional US$ 10 billion per year.

World Health Organization.

Version: 2016

The management of myeloma is complex and challenging. It increasingly involves the use of expensive drugs. The guideline will aim to raise standards nationally while allowing clinical flexibility and defining a common pathway for patients at various stages of their illness, and of different ages and levels of fitness. Although a consistent approach to management is desirable, it needs to reflect the very different groups of patients with myeloma from the fit and suitable for transplant, fairly fit but not suitable for transplant to patients who are extremely frail and/or unwell.

NICE Guideline - National Collaborating Centre for Cancer (UK).

Version: February 2016

This clinical guideline was commissioned by NICE and developed by the National Collaborating Centre for Mental Health. It sets out clear, evidenceand consensus-based recommendations for healthcare staff on how to treat and manage depression in adults with a chronic physical health problem.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2010

Infective endocarditis (IE) is a rare condition with significant morbidity and mortality. It may arise following bacteraemia in a patient with a predisposing cardiac lesion. In an attempt to prevent this disease, over the past 50 years, at-risk patients have been given antibiotic prophylaxis before dental and certain non-dental interventional procedures.

NICE Clinical Guidelines - National Institute for Health and Clinical Excellence (UK).

Version: March 2008

To conduct a systematic review of the use of pharmacokinetic/pharmacodynamic (PK/PD) measures or strategies to dose and monitor intravenous (IV) antibiotics in the treatment of adults with hospital-acquired pneumonia (HAP).

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: November 2014

This guideline makes recommendations on the prevention, diagnosis and management of latent and active tuberculosis (TB), including both drug susceptible and drug resistant forms of the disease. It covers the organisation of relevant TB services. It relates to activities undertaken in any setting in which NHS or public health services for TB are received, provided or commissioned in the public, private and voluntary sectors.

NICE Guideline - Internal Clinical Guidelines Team (UK).

Version: January 2016

Despite the publication of strategies on commissioning specialist services for the management and prevention of diabetic foot problems in hospital (‘Putting feet first’, Diabetes UK 2009; ‘Improving emergency and inpatient care for people with diabetes’, Department of Health 2008), there is variation in practice in the inpatient management of diabetic foot problems. This variation is due to a range of factors, including differences in the organisation of care between patients' admission to an acute care setting and discharge. This variability depends on geography, individual trusts, individual specialties (such as whether the service is managed by vascular surgery, general surgery, orthopaedics, diabetologists or general physicians) and the availability of podiatrists with expertise in diabetic foot disease.

NICE Clinical Guidelines - National Institute for Health and Clinical Excellence (UK).

Version: March 2011

Despite the publication of strategies on commissioning specialist services for preventing and managing diabetic foot problems, there is variation in practice across different NHS settings, and amputation rates still vary up to fourfold in the UK.

NICE Guideline - Internal Clinical Guidelines team.

Version: August 2015

Clinical guidelines have been defined as ‘systematically developed statements which assist clinicians and patients in making decisions about appropriate treatment for specific conditions’. This guideline has been developed with the aim of providing guidance on the care of children with bronchiolitis.

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

Version: June 2015

CADTH undertook a study into antibiotic prescribing and use in Canadian primary care practice, with a particular emphasis on fluoroquinolone use. The study investigated current practices and implementation issues for antibiotic therapies from the perspective of family physicians (FPs), nurse practitioners (NPs), and pharmacists. The research findings are based on the results of qualitative research in the form of surveys of primary care practitioners, as well as on a targeted review of the literature on fluoroquinolones use in Canada. CADTH sought to understand and explain experiences and decision-making processes around outpatient prescribing of antibiotics for specific indications. This report presents a summary of the findings.

CADTH Technology Review - Canadian Agency for Drugs and Technologies in Health.

Version: May 2017

Since the publication of the NICE clinical guideline on the prevention of healthcare-associated infections (HCAI) in primary and community care in 2003, many changes have occurred within the NHS that place the patient firmly at the centre of all activities. First, the NHS Constitution for England defines the rights and pledges that every patient can expect regarding their care. To support this, the Care Quality Commission (CQC), the independent regulator of all health and adult social care in England, ensures that health and social care is safe, and monitors how providers comply with established standards. In addition, the legal framework that underpins the guidance has changed since 2003.

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

Version: March 2012

The guideline covers the identification and assessment of suspected cirrhosis, monitoring to detect complications and management of complications such as ascites and hepatorenal syndrome and referral for tertiary care.

NICE Guideline - National Guideline Centre (UK).

Version: July 2016

The study found that it is feasible to address several of the important problems faced by guideline developers when attempting to account for multimorbidity.

Health Services and Delivery Research - NIHR Journals Library.

Version: April 2017

The majority of antimicrobials prescribed to humans originate in outpatient settings. In making prescribing decisions, primary care providers are faced with patient expectations, and with patient and provider lack of awareness of antimicrobial resistance and lack of understanding of the seriousness of the antimicrobial resistance problem.

Evidence-based Synthesis Program - Department of Veterans Affairs (US).

Version: February 2014

Postoperative endophthalmitis is one of the most serious potential complications of ocular lens surgery. Its incidence can be reduced by means of antibiotic prophylaxis. Although the prophylactic use of intracameral cefuroxime has been extended, other drugs, such as moxifloxacin, have arisen as alternatives. We performed a systematic literature review on the effectiveness and efficiency of intracameral cefuroxime and moxifloxacin for the prophylaxis of postoperative endophthalmitis after cataract surgery. Several bibliographic databases were searched up to October 2010 and were updated up to January 2013. Outcomes were the onset of endophthalmitis after surgery and the cost-effectiveness ratio of using both antibiotic prophylaxis alternatives. The following were included: a clinical trial reported in two papers, six observational studies, and an economic evaluation. All studies assessed cefuroxime compared with another antibiotic prophylaxis or no prophylaxis. The only randomized controlled trial performed by the European Society of Cataract and Refractive Surgery found that intracameral cefuroxime is significantly more effective than not using prophylaxis or the use of a topical antibiotic. The observational studies support these results. The economic evaluation compared different prophylaxis regimens and concluded that intracameral cefuroxime showed the best cost-effectiveness ratio. Both the observational studies and the economic evaluation have methodological limits that reduce their validity. This review confirmed that cefuroxime can prevent endophthalmitis after cataract surgery. Further randomized controlled trials, with large sample sizes, are required to compare different antibiotic prophylaxis regimens.

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

Version: 2014

A recent systematic review concluded that there is insufficient evidence on the effectiveness to support or reject preventive therapy for treatment of contacts of patients with multidrug resistant tuberculosis (MDR-TB). Whether preventive therapy is favorable depends both on the effectiveness and the adverse events of the drugs used. We performed a systematic review to assess adverse events in healthy individuals and MDR-TB contacts treated with anti-tuberculosis drugs potentially effective for preventing development of MDR-TB. We searched MEDLINE, EMBASE, and other databases (August 2011). Record selection, data extraction, and study quality assessment were done in duplicate. The quality of evidence was assessed using the GRADE approach. Of 6,901 identified references, 20 studies were eligible. Among the 16 studies in healthy volunteers (a total of 87 persons on either levofloxacin, moxifloxacin, ofloxacin, or rifabutin, mostly for 1 week), serious adverse events and treatment discontinuation due to adverse events were rare (<1 and <5%, respectively), but mild adverse events frequently occurred. Due to small sample sizes of the levofloxacin and ofloxacin studies an increased frequency of mild adverse events compared to placebo could not be demonstrated or excluded. For moxifloxacin the comparative results were inconsistent. In four studies describing preventive therapy of MDR-TB contacts, therapy was stopped for 58-100% of the included persons because of the occurrence of adverse events ranging from mild adverse events such as nausea and dizziness to serious events requiring treatment. The quality of the evidence was very low. Although the number of publications and quality of evidence are low, the available evidence suggests that shortly after starting treatment the occurrence of serious adverse events is rare. Mild adverse events occur more frequently and may be of importance because these may provoke treatment interruption.

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

Version: 2013

Systematic Reviews in PubMed

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