As part of the Choosing Wisely campaign, the Infectious Diseases Society of America has released its list of five tests and treatments that physicians and patients should question:
1. Antibiotics should not be used to treat bacteria in the urine if the patient does not have symptoms, unless she is pregnant.
2. Physicians should avoid prescribing antibiotics for upper respiratory infections since most are viral. There are specific guidelines, about when antibiotics can be used.
3. Antibiotics should be avoided for stasis dermatitis of the legs, a condition where the lower leg is red and mildly swollen due to a number of reasons. Discuss the causes with your doctor. The standard of care is leg elevation plus compression stockings.
4. In the absence of diarrhea, physicians should not test for Clostridium difficile.
5. Antibiotic prophylaxis should not be given to patients with mitral valve prolapse to prevent heart infections. The guidelines have changed, please discuss this with your doctor, before routinely taking antibiotics for dental, and other procedures.
Death from pneumonia and influenza in the U.S. has reached an epidemic level, according to CDC data released last week. Pneumonia and influenza accounted for 6.9% of all deaths. Twenty- six pediatric deaths have been reported to date.
The CDC previously warned that this flu season is likely to be severe because the predominant virus in circulation, H3N2, is known for being particularly virulent, especially in children under five and adults over sixty-five; in addition, the circulating H3N2 strains are not well matched to the H3N2 strain included in this season’s flu vaccine. However, all flu samples tested thus far have been susceptible to the antiviral treatment options available like Tamiflu and Relenza. On December 19, 2014, the FDA approved a third antiviral, Rapivab, to treat influenza infection in adults.
For more information on the flu, click on this link, or copy and paste to your browser. CDC FluView
Roughly half of the circulating influenza A viruses collected in the U.S. early this flu season are a different virus strain than included in this year’s vaccine, prompting CDC officials to remind healthcare providers about using medications like Tamiflu or Relenza aggressively to treat and prevent influenza.
“They’re different enough that we’re concerned that protection from vaccination may be lower than we usually see,” CDC Director Tom Frieden told reporters on Thursday.
The CDC is still recommending that people get vaccinated against the flu because it provides partial protection and the B strains are well matched. But Frieden said that if clinicians suspect influenza in high-risk patients, they should start Tamifu without waiting for confirmatory test results.
CDC health advisory