DOCSLIB.ORG

Sore Throat (Acute): Antimicrobial Prescribing Guideline Evidence Review

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Sore Throat (Acute): Antimicrobial Prescribing Guideline Evidence Review National Institute for Health and Care Excellence APG: sore throat (acute) - draft for consultation Sore throat (acute): antimicrobial prescribing guideline Evidence review July 2017 Draft for Consultation DRAFT FOR CONSULTATION Contents Disclaimer The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian. Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties. NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the Welsh Government, Scottish Government, and Northern Ireland Executive. All NICE guidance is subject to regular review and may be updated or withdrawn. Copyright © National Institute for Health and Care Excellence, 2017. All rights reserved. ISBN: DRAFT FOR CONSULTATION Contents Contents Contents .............................................................................................................................. 4 1 Context .......................................................................................................................... 6 1.1 Background ........................................................................................................... 6 1.2 Managing self-limiting infections ............................................................................ 6 1.2.1 Self-care .................................................................................................... 7 1.2.2 No antibiotic prescribing strategies ............................................................. 7 1.2.3 Antibiotic prescribing strategies .................................................................. 8 1.3 Safety netting advice ............................................................................................. 8 1.4 Symptoms and signs of a more serious illness or condition (red flags) .................. 9 2 Evidence selection ..................................................................................................... 10 2.1 Literature search ................................................................................................. 10 2.2 Summary of included studies............................................................................... 10 3 Clinical effectiveness ................................................................................................. 16 3.1 Non-pharmacological interventions ..................................................................... 16 3.2 Non-antimicrobial pharmacological interventions ................................................. 16 3.2.1 Oral analgesia in adults ............................................................................ 16 3.2.2 Medicated lozenges in adults ................................................................... 17 3.2.3 Benzocaine lozenges ............................................................................... 17 3.2.4 Hexylresorcinol lozenges ......................................................................... 17 3.2.5 Flurbiprofen lozenges............................................................................... 17 3.2.6 Throat sprays ........................................................................................... 18 3.2.7 Corticosteroids ......................................................................................... 18 3.3 Antimicrobials ...................................................................................................... 19 3.3.1 Delayed antibiotics ................................................................................... 19 3.3.2 Antibiotics compared with placebo ........................................................... 20 3.3.3 Identifying people more likely to have a bacterial infection ....................... 20 3.3.4 Antibiotics compared with other antibiotics ............................................... 21 3.3.5 Frequency of antibiotic dosing .................................................................. 22 3.3.6 Antibiotic course length ............................................................................ 23 4 Safety and tolerability ................................................................................................ 24 4.1 Non-pharmacological interventions ..................................................................... 24 4.2 Non-antimicrobial pharmacological interventions ................................................. 24 4.2.1 Oral analgesia .......................................................................................... 24 4.2.2 Medicated lozenges ................................................................................. 24 4.2.3 Throat sprays ........................................................................................... 24 4.2.4 Corticosteroids ......................................................................................... 25 4.3 Antimicrobials ...................................................................................................... 25 4.3.1 Delayed antibiotics ................................................................................... 25 4.3.2 Antibiotics versus placebo ........................................................................ 26 4 DRAFT FOR CONSULTATION Contents 4.3.3 Antibiotics versus another antibiotic ......................................................... 26 5 Resistance .................................................................................................................. 27 6 Other considerations ................................................................................................. 28 6.1 Resource impact ................................................................................................. 28 6.2 Medicines adherence .......................................................................................... 28 7 Terms used in the guideline ...................................................................................... 29 Centor criteria ...................................................................................................... 29 Sore Throat Pain Intensity Scale (STPIS) ............................................................ 29 Sum of Pain Intensity Difference (SPID) .............................................................. 29 Tonsillo- Pharyngitis Assessment (TPA) .............................................................. 29 Total pain relief (TOTPAR) .................................................................................. 29 Throat Pain Scale ................................................................................................ 29 Appendices ........................................................................................................................ 30 Appendix A: Review protocol ..................................................................................... 30 Appendix B: Literature search strategy ..................................................................... 37 Appendix C: Study flow diagram ................................................................................ 43 Appendix D: Included studies ..................................................................................... 44 Appendix E: Quality assessment of included studies .............................................. 47 E.1 Oral analgesia ............................................................................................................. 47 E.2 Lozenges ..................................................................................................................... 49 E.3 Throat spray ................................................................................................................ 51 E.4 Corticosteroids ........................................................................................................... 52 E.5 Antimicrobials ............................................................................................................ 53 E.6 Clinical scoring systems and rapid antigen testing ................................................. 56 Appendix F: GRADE profiles ...................................................................................... 58 F.1 Oral analgesia ............................................................................................................. 58 F.2 Lozenges ..................................................................................................................... 63 F.3 Throat spray ...............................................................................................................
Load more

Recommended publications
  • NOTE: the Following Are Shirley Ryan Abilitylab's Standard Charges As of Jan. 1, 2019. These Standard Charges Often Do Not
    NOTE: The following are Shirley Ryan AbilityLab's standard charges as of Jan. 1, 2019. These standard charges often do not reflect what a patient or their insurance company/payer may be required to pay. Contact Patient Financial Services at 312-238-6039 for more information. Description Price 11-Deoxycortisol, Urine Random $531 12 Lead Ekg, Tracing Only $245 17 Hydroxycorticosteroids, Urine Timed $363 17 Hydroxyprogesterone, Serum $172 17 Ketosteroids, Urine Timed $273 17-Ketosteroids with Creatinine, Urine Random $273 2D Gait Analysis Charge(95999) $2,174 5' Nucleotidase, Serum $269 5.5 PDC PEDS CUFFED TRACH $226 5-HIAA-24 Hr Urine $99 A4566 Shoulder sling or vest design, abduction res $226 A4595 FES Electrode, each $38 A6545 Gradient Compression Wrap, Non-Elastic, Belo $171 ABO Rh Type $106 Above Knee Nylon Hose PR $83 Above Knee Suction Sheath $131 Above knee, for proximal femoral focal deficiency, $14,344 Above knee, molded socket, open end, SACH foot, en $10,751 Above knee, molded socket, single axis constant fr $10,935 Above knee, short prosthesis, no knee joint (""stu_L5210 $8,682 Above knee, short prosthesis, no knee joint (""stu_L5220 $7,429 ACAPELLA DH GREEN VIBRATORY PEP W/MOUTHPIECE DEVIC $181 Acetabuloplasty (27120) $4,493 Acetone, Serum $27 Acetylcholine Receptor Binding Antibody $405 Acid Phosphatase $66 Acid Phosphatase, Prostatic fraction $66 ACNE SURGERY MILIA CYSTS (10040) $530 Acorn Nebulizer $174 Activated PTT/Partial Thromboplastin Time $109 Active Wound Care > 20 cm Units $171 Active Wound Care/20 cm or < Units $171 Acupuncture with E-Stim. Each additional 15 minute $65 Acupuncture with E-Stim.
    [Show full text]
  • Tonsillopharyngitis - Acute (1 of 10)
    Tonsillopharyngitis - Acute (1 of 10) 1 Patient presents w/ sore throat 2 EVALUATION Yes EXPERT Are there signs of REFERRAL complication? No 3 4 EVALUATION Is Group A Beta-hemolytic Yes DIAGNOSIS Streptococcus (GABHS) • Rapid antigen detection test infection suspected? (RADT) • roat culture No TREATMENT EVALUATION No A Supportive management Is GABHS confi rmed? B Pharmacological therapy (Non-GABHS) Yes 5 TREATMENT A EVALUATE RESPONSEMIMS Supportive management TO THERAPY C Pharmacological therapy • Antibiotics Poor/No Good D Surgery, if recurrent or complicated response response REASSESS PATIENT COMPLETE THERAPY & REVIEW THE DIAGNOSIS© Not all products are available or approved for above use in all countries. Specifi c prescribing information may be found in the latest MIMS. B269 © MIMS Pediatrics 2020 Tonsillopharyngitis - Acute (2 of 10) 1 ACUTE TONSILLOPHARYNGITIS • Infl ammation of the tonsils & pharynx • Etiologies include bacterial (group A β-hemolytic streptococcus, Haemophilus infl uenzae, Fusobacterium sp, etc) & viral (infl uenza, adenovirus, coronavirus, rhinovirus, etc) pathogens • Sore throat is the most common presenting symptom in older children TONSILLOPHARYNGITIS 2 EVALUATION FOR COMPLICATIONS • Patients w/ sore throat may have deep neck infections including epiglottitis, peritonsillar or retropharyngeal abscess • Examine for signs of upper airway obstruction Signs & Symptoms of Sore roat w/ Complications • Trismus • Inability to swallow liquids • Increased salivation or drooling • Peritonsillar edema • Deviation of uvula
    [Show full text]
  • NINDS Custom Collection II
    ACACETIN ACEBUTOLOL HYDROCHLORIDE ACECLIDINE HYDROCHLORIDE ACEMETACIN ACETAMINOPHEN ACETAMINOSALOL ACETANILIDE ACETARSOL ACETAZOLAMIDE ACETOHYDROXAMIC ACID ACETRIAZOIC ACID ACETYL TYROSINE ETHYL ESTER ACETYLCARNITINE ACETYLCHOLINE ACETYLCYSTEINE ACETYLGLUCOSAMINE ACETYLGLUTAMIC ACID ACETYL-L-LEUCINE ACETYLPHENYLALANINE ACETYLSEROTONIN ACETYLTRYPTOPHAN ACEXAMIC ACID ACIVICIN ACLACINOMYCIN A1 ACONITINE ACRIFLAVINIUM HYDROCHLORIDE ACRISORCIN ACTINONIN ACYCLOVIR ADENOSINE PHOSPHATE ADENOSINE ADRENALINE BITARTRATE AESCULIN AJMALINE AKLAVINE HYDROCHLORIDE ALANYL-dl-LEUCINE ALANYL-dl-PHENYLALANINE ALAPROCLATE ALBENDAZOLE ALBUTEROL ALEXIDINE HYDROCHLORIDE ALLANTOIN ALLOPURINOL ALMOTRIPTAN ALOIN ALPRENOLOL ALTRETAMINE ALVERINE CITRATE AMANTADINE HYDROCHLORIDE AMBROXOL HYDROCHLORIDE AMCINONIDE AMIKACIN SULFATE AMILORIDE HYDROCHLORIDE 3-AMINOBENZAMIDE gamma-AMINOBUTYRIC ACID AMINOCAPROIC ACID N- (2-AMINOETHYL)-4-CHLOROBENZAMIDE (RO-16-6491) AMINOGLUTETHIMIDE AMINOHIPPURIC ACID AMINOHYDROXYBUTYRIC ACID AMINOLEVULINIC ACID HYDROCHLORIDE AMINOPHENAZONE 3-AMINOPROPANESULPHONIC ACID AMINOPYRIDINE 9-AMINO-1,2,3,4-TETRAHYDROACRIDINE HYDROCHLORIDE AMINOTHIAZOLE AMIODARONE HYDROCHLORIDE AMIPRILOSE AMITRIPTYLINE HYDROCHLORIDE AMLODIPINE BESYLATE AMODIAQUINE DIHYDROCHLORIDE AMOXEPINE AMOXICILLIN AMPICILLIN SODIUM AMPROLIUM AMRINONE AMYGDALIN ANABASAMINE HYDROCHLORIDE ANABASINE HYDROCHLORIDE ANCITABINE HYDROCHLORIDE ANDROSTERONE SODIUM SULFATE ANIRACETAM ANISINDIONE ANISODAMINE ANISOMYCIN ANTAZOLINE PHOSPHATE ANTHRALIN ANTIMYCIN A (A1 shown) ANTIPYRINE APHYLLIC
    [Show full text]
  • Quantitative Assessment of Antimicrobial Activity of PLGA Films Loaded with 4-Hexylresorcinol
    Journal of Functional Biomaterials Article Quantitative Assessment of Antimicrobial Activity of PLGA Films Loaded with 4-Hexylresorcinol Michael Kemme * and Regina Heinzel-Wieland Department of Chemical Engineering and Biotechnology, Hochschule Darmstadt, University of Applied Sciences, Stephanstrasse 7, 64295 Darmstadt, Germany; [email protected] * Correspondence: [email protected]; Tel.: +49-6151-1638631 Received: 18 December 2017; Accepted: 9 January 2018; Published: 11 January 2018 Abstract: Profound screening and evaluation methods for biocide-releasing polymer films are crucial for predicting applicability and therapeutic outcome of these drug delivery systems. For this purpose, we developed an agar overlay assay embedding biopolymer composite films in a seeded microbial lawn. By combining this approach with model-dependent analysis for agar diffusion, antimicrobial potency of the entrapped drug can be calculated in terms of minimum inhibitory concentrations (MICs). Thus, the topical antiseptic 4-hexylresorcinol (4-HR) was incorporated into poly(lactic-co-glycolic acid) (PLGA) films at different loadings up to 3.7 mg/cm2 surface area through a solvent casting technique. The antimicrobial activity of 4-HR released from these composite films was assessed against a panel of Gram-negative and Gram–positive bacteria, yeasts and filamentous fungi by the proposed assay. All the microbial strains tested were susceptible to PLGA-4-HR films with MIC values down to 0.4% (w/w). The presented approach serves as a reliable method in screening and quantifying the antimicrobial activity of polymer composite films. Moreover, 4-HR-loaded PLGA films are a promising biomaterial that may find future application in the biomedical and packaging sector.
    [Show full text]
  • Chewable Lozenge Formulation
    Umashankar M S et al. Int. Res. J. Pharm. 2016, 7 (4) INTERNATIONAL RESEARCH JOURNAL OF PHARMACY www.irjponline.com ISSN 2230 – 8407 Review Article CHEWABLE LOZENGE FORMULATION- A REVIEW Umashankar M S *, Dinesh S R, Rini R, Lakshmi K S, Damodharan N SRM College of Pharmacy, SRM University, Kattankulathur, India *Corresponding Author Email: [email protected] Article Received on: 11/02/16 Revised on: 13/03/16 Approved for publication: 28/03/16 DOI: 10.7897/2230-8407.07432 ABSTRACT Development of lozenges dated back to 20thcentury and is still remain popular among the consumer and hence it has continued commercial production. Lozenges are palatable solid unit dosage form administrated in the oral cavity. They meant to be dissolved in mouth or pharynx for its local or systemic effect. Lozenge tablets provide several advantages as pharmaceutical formulations however with some disadvantages. Lozenge as a dosage form can be adopted for drug delivery across buccal route, labial route, gingival route and sublingual route. Multiple drugs can also be incorporated in them for chronic illness treatments. Lozenge enables loading of wide range of active ingredients for oral systemic delivery of drugs. Lozenges are available as over the counter medications in the form of caramel based soft lozenges, hard candy lozenges and compressed tablet lozenges containing drugs for sore throat, mouth infection and as mouth fresheners. The rationale behind the use of medicated lozenges as one of the most favored dosage form for the delivery of antitussive drugs. This review focuses various aspects of lozenge formulation providing an insight to the formulation scientist on novel application of lozenge drug delivery system.
    [Show full text]
  • Substantial Equivalence Determination Decision Summary Assay Only Template
    510(k) SUBSTANTIAL EQUIVALENCE DETERMINATION DECISION SUMMARY ASSAY ONLY TEMPLATE A. 510(k) Number: k091024 B. Purpose for Submission: Premarket notification C. Measurand: Methicillin Resistant Staphylococcus aureus (MRSA) D. Type of Test: Detection of MRSA using a selective and differential chromogenic media E. Applicant: bioMérieux, Inc. F. Proprietary and Established Names: chromID™ MRSA Agar G. Regulatory Information: 1. Regulation section: 21 CFR 866.1700 2. Classification: Class II 3. Product code: JSO Culture media, Antimicrobial susceptibility test, excluding Mueller Hinton Agar 1 4. Panel: Microbiology H. Intended Use: 1. Intended use(s): chromID™ MRSA agar is a selective and differential chromogenic medium for the qualitative detection of nasal colonization of methicillin resistant Staphylococcus aureus (MRSA) to aid in the prevention and control of MRSA infections in healthcare settings. The test is performed on anterior nares swab specimens from patients and healthcare workers to screen for MRSA colonization. chromID™ MRSA agar is not intended to diagnose MRSA infection nor to guide or monitor treatment of infection. 2. Indication(s) for use: The chromID™ MRSA agar is not intended to diagnose MRSA infection nor to guide or monitor treatment of infection. 3. Special conditions for use statement(s): Prescription use 4. Special instrument requirements: Not applicable I. Device Description: The chromID™ MRSA agar is translucent and a light tan color. After the plates are inoculated and incubated, colonies growing on the plates will have either a green appearance, which indicates a positive MRSA status or a colorless appearance which indicates a negative MRSA status. The green color is more vivid if the colonies are observed through the agar from the bottom of the plate.
    [Show full text]
  • Adverse Effects and Precautions
    1736 Disinfectants and Preservatives i Amylmetacresoi (BAN, riNN) ..................Preparat ons........ Adverse Effects and Precautions ProprietaryPreparations (details are given in Volume B) The alkyl gallates may cause contact sensitivity and skin Aml!metacreso!; A[ililrnetakrezol: Amylrnet.acreso[; Amylrne.­ AM<InM<;· Multi-ingredient Preparations. Singapore: Esemdent. reactions. ta�resolurn; Amylmetakresol: Amyylirnetakresoli; TaKpe30J1. Effects on the blood. Methaemoglobinaemia associated 6-Pentyl-rn,cresol; S;Methyl.-2-pentylpheooi. Alkyl Gallates with the antoxidants (butylated hydroxyanisole, butylated C1 J1,80= 178.3 hydroxytoluene, and propyl gallate) used to preserve the CAS 1300,94-3. .de Gaiatos alquilo; AnKwnrannalJ:>t. oil in a soybean infant feed fom1ula has been reported.1 UN!! -'-· 05W904P57F: Propyl gallate was suspected of being the most likely cause Dodecyl Gallate because its chemical structure is similar to pyrogallol Pharmacopoeias. In Bur. (see p. vii). (p. 1718.2), a methaemoglobinaemia inducer. Ph. Eur. 8: (Amylmetacresol). A clear or almost clear liquid Dodecilo galatas; Dociecyle,. gallate Dodecylgallat; . de; ..•. I. Nitzan M, et al. Infantile methemoglobinemia caused by food additives. or a solid crystalline mass, colourless or slightly yellow Dodecyi-9Jilat; D(0ec%lis (iallas:. Dodekyyligallaattl; E312; Clin Toxicol 1979; 15: 273-80. when freshly prepared; it darkens or discolours to dark m Galata • de dodecflo; Laury! Gailate; Laurylum Gafikw ; yellow, brownish-yellow, or pink on keeping. F.p. about 22 }logel\vfn rarinar. Preparations degrees. Practically insoluble in water; very soluble in Dodecyi 3,4,5-trihyc;lroxybenzoate. ...................... alcohol and in acetone. Store in non�metallic airtight (details are given in Volume B) C;ul;lje0$=338.4 ProprietaryPreparations containers. Protect from light.
    [Show full text]
  • Clinical Excellence Series Volume VI an Evidence-Based Approach to Infectious Disease
    Clinical Excellence Series n Volume VI An Evidence-Based Approach To Infectious Disease Inside The Young Febrile Child: Evidence-Based Diagnostic And Therapeutic Strategies Pharyngitis In The ED: Diagnostic Challenges And Management Dilemmas HIV-Related Illnesses: The Challenge Of Emergency Department Management Antibiotics In The ED: How To Avoid The Common Mistake Of Treating Not Wisely, But Too Well Brought to you exclusively by the publisher of: An Evidence-Based Approach To Infectious Disease CEO: Robert Williford President & Publisher: Stephanie Ivy Associate Editor & CME Director: Jennifer Pai • Associate Editor: Dorothy Whisenhunt Director of Member Services: Liz Alvarez • Marketing & Customer Service Coordinator: Robin Williford Direct all questions to EB Medicine: 1-800-249-5770 • Fax: 1-770-500-1316 • Non-U.S. subscribers, call: 1-678-366-7933 EB Medicine • 5550 Triangle Pkwy Ste 150 • Norcross, GA 30092 E-mail: [email protected] • Web Site: www.ebmedicine.net The Emergency Medicine Practice Clinical Excellence Series, Volume Volume VI: An Evidence-Based Approach To Infectious Disease is published by EB Practice, LLC, d.b.a. EB Medicine, 5550 Triangle Pkwy Ste 150, Norcross, GA 30092. Opinions expressed are not necessarily those of this publication. Mention of products or services does not constitute endorsement. This publication is intended as a general guide and is intended to supplement, rather than substitute, professional judgment. It covers a highly technical and complex subject and should not be used for making specific medical decisions. The materials contained herein are not intended to establish policy, procedure, or standard of care. Emergency Medicine Practice, The Emergency Medicine Practice Clinical Excellence Series, and An Evidence-Based Approach To Infectious Disease are trademarks of EB Practice, LLC, d.b.a.
    [Show full text]
  • AP76: 4-Hexyl-Resorcinol CAS#: 136-77-6
    the art and science of smart patch testingTM AP76: 4-hexyl-resorcinol CAS#: 136-77-6 Patient Information Your patch test result indicates that you have a contact allergy to 4-hexyl- resorcinol. This contact allergy may cause your skin to react when it is exposed to this substance although it may take several days for the symptoms to appear. Typical symptoms include redness, swelling, itching, and fluid-filled blisters. Where is 4-hexyl-resorcinol found? 4-hexyl-resorcinol has a long history of human pharmaceutical use as a topical skin and mucosal disinfectant for treatment of superficial wounds, and as a component of soaps, handwashes, and skin cleaners. 4-hexyl-resorcinol has been used in dilute solutions as antiseptic gargles or throat spray, and in lozenges. 4-hexyl-resorcinol is still marketed today as an ingredient of certain throat lozenges. How can you avoid contact with 4-hexyl-resorcinol? Avoid products that list any of the following names in the ingredients: 1,3-Benzenediol, 4-hexyl- Cystoids anthelmintic 1,3-Dihydroxy-4-hexylbenzene EINECS 205-257-4 1,3-Dihydroxy-4-n-hexylbenzene Gelovermin 4-(1-Hexyl)resorcinol Hexylresorcin [German] 4-06-00-06048 (Beilstein Handbook Ref) Hexylresorcinol 4-Hexyl-1,3-benzenediol Hexylresorcinolum 4-Hexyl-1,3-dihydroxybenzene Hexylresorzin 4-Hexylresorcine Hidesol 4-n-Hexylresorcinol HSDB 566 Adrover NCI-C55787 AI3-08055 NSC 1570 Antascarin Oxana Ascaricid p-Hexylresorcinol Ascarinol Prensol Ascaryl Resorcinol, 4-hexyl- BRN 2048312 S.T. 37 Caprokol ST 37 CCRIS 888 ST-37 Crystoids Worm-agen What are some products that may contain 4-hexyl-resorcinol? Cosmetics: Clearasil Adult Care Lotions and Skin Care: KOPNOL Mouthwash / Gargle Throat Lozenges: Sucrets Throat Spray *For additional information about products that might contain 4-hexyl-resorcinol, go to the Household Product Database online (http:/householdproducts.nlm.nih.gov) at the United States National Library of Medicine.
    [Show full text]
  • Sore Throats
    Pharyngitis Viruses cause most sore throats. When viruses infect your nose, $\/�P�1S1N(f F'ac+s: throat and sinuses, your body fightsback by making mucus. This helps Only about 15% of the people who wash out viruses. The mucus from your nose and sinuses drains into go to a doctor with a bad sore your throat. It can make your throat feel sore. Allergies, smoking, and throat have strep throat. You need air pollution can also lead to a sore throat. Some sore throats happen a test to tell for sure. You only need when stomach acid comes up into the throat. Yelling or speaking for a antibiotics if your test shows you long time can also make the throat sore. have strep throat. WJ.1affo l)O: Antibiotics don't work against viral infections. A sore throat • Drink more water. Honey and from a virus will get better on its own within a week or two. Antibiotics lemon in hot water or herbal teas won't make a sore throat go away any faster if it is caused by a virus. are good, too. Do not give honey Taking antibiotics when they are not needed may harm you by creating to children under 1. stronger germs. • Gargle with warm salt water. Talk with your health care provider about medicines that can help you • Suck on a hard candy, vitamin C feel better. For sore throats caused by allergies, your provider can help drop or throat lozenge. Do not give to young children. you figureout how to avoid the things that trigger your allergies.
    [Show full text]
  • Submission Demonstrates That Flurbiprofen Lozenges Do Not Need to Be Restricted to Pharmacy Only Status Given;
    Flurbiprofen reclassification to Unscheduled Medicine Reckitt Benckiser __________________________________________________________________________________________ Reclassification of a Medicine for consideration by the Medicine Classification Committee Application for the reclassification of flurbiprofen lozenges (8.75 mg flurbiprofen per lozenge) from Pharmacy Only Medicine to General Sale (Unscheduled) Medicine 30 June 2020 Submitted by: Reckitt Benckiser (New Zealand) Pty Limited Level 47 / 680 George Street Sydney NSW 2000, Australia 1 | Page Flurbiprofen reclassification to Unscheduled Medicine Reckitt Benckiser __________________________________________________________________________________________ Table of Contents Executive Summary ................................................................................................................ 4 Part A ..................................................................................................................................................... 7 1. International Non-proprietary Name of the medicine. ........................................................ 7 2. Proprietary name(s). ................................................................................................................ 7 3. Name and contact details of the company / organisation / individual requesting a reclassification. ............................................................................................................................. 7 4. Dose form(s) and strength(s) for which a change is
    [Show full text]
  • Study Protocol
    Study Protocol Proposed methodology to measure the impact of GRIP toolkit materials on antibiotic prescribing for URTIs by primary care physicians The method described here illustrates the process for assessment of one specific symptom of upper respiratory tract infection (URTI), sore throat. This has been selected as the Centor criteria may be used to predict the likelihood of a group A streptococcal bacterial infection in patients complaining of acute sore throat1 while other common URTI symptoms are likely to be due to viral infection. This protocol can be adapted for other URTI symptoms. Using this protocol and analysing the collected data can help understand: • The impact of GRIP toolkit materials on antibiotic prescribing in URTIs • Thether current level of antibiotic use is indicated (e.g. in non-high risk patients) Study arms • Control arm: no access to GRIP toolkit materials (n=tbc) • Test arm: full access to GRIP toolkit materials (n=tbc) Test arm: GRIP URTI toolkit preparation prior to assessment If you are part of the control arm and will not be using the toolkit during this assessment, you do not need to read this section. Please go straight to the patient section below. Preparation and planning • Review current personal and colleague management practices when dealing with URTIs, specifically acute sore throat • Ensure each doctor within the test arm has read and understood the toolkit materials • Identify any differences between current practice versus that advised in the GRIP toolkit Defining use of the GRIP toolkit There are four ways the GRIP toolkit can be used by the test arm.
    [Show full text]