Less Is More

Simpler & Better Medicine

Penicillin for 5 or 10 days for Group A streptococcal pharnygitis. — December 31, 2019

Penicillin for 5 or 10 days for Group A streptococcal pharnygitis.

Summary: For patients over age 6 years with group A streptococcal pharnygitis meeting at least 3 of the Centor Criteria, treatment with Penicillin V 800 mg 4x daily for 5 days may be associated with a slightly shorter time to relief of symptoms and a lower likelihood of adverse events such as diarrhea, nausea, and vulvovaginal symptoms compared to treatment with Penicillin V 1000 mg 3x daily for 10 days; both approaches may be associated with the same likelihood (~ 90%) of clinical cure after 5-7 days.

https://www.ncbi.nlm.nih.gov/m/pubmed/31585944/

Strength of Recommendation = A

Delayed antibiotic prescribing strategies for respiratory tract infections in primary care. — May 14, 2019

Delayed antibiotic prescribing strategies for respiratory tract infections in primary care.

Summary: For patients with acute respiratory infections who are not judged clinically to need immediate antibiotic treatment, any of several “delayed antibiotic prescription” approaches are associated fewer patients using antibiotics compared to an approach of giving an immediate antibiotic prescription (approximately 3-4 out of 10 compared to 9 out of 10); while giving an immediate antibiotic prescription is not associated with any shorter duration of illness or any lower symptom scores.

https://www.ncbi.nlm.nih.gov/m/pubmed/24603565

Strength of Recommendation = B

Association of Long-Term Risk of Respiratory, Allergic, and Infectious Diseases With Removal of Adenoids and Tonsils in Childhood. — July 3, 2018

Association of Long-Term Risk of Respiratory, Allergic, and Infectious Diseases With Removal of Adenoids and Tonsils in Childhood.

Summary: For children under 10 years of age, surgical removal of the tonsils, adenoids, or both may be associated with an increased long-term risk of respiratory, infectious, and allergic diseases; without any significant change in the long-term risks for conditions that these surgeries aim to treat.

https://www.ncbi.nlm.nih.gov/m/pubmed/29879264/

Strength of Recommendation = B

Healing of intraoral wounds closed using silk sutures and isoamyl 2-cyanoacrylate glue. — August 16, 2016

Healing of intraoral wounds closed using silk sutures and isoamyl 2-cyanoacrylate glue.

Summary: For patients having intra-oral procedures, surgical closure with cyanoacrylate glue appears to lead to the same degree of wound-healing by 2 weeks as does closure with silk sutures, but cyanoacrylate glue appears to be associated with less short-term inflammation.

http://www.ncbi.nlm.nih.gov/m/pubmed/23089654

Strength of Recommendation = B

Prescription Strategies in Acute Uncomplicated Respiratory Infections: A Randomized Clinical Trial. — March 11, 2016

Prescription Strategies in Acute Uncomplicated Respiratory Infections: A Randomized Clinical Trial.

Summary: For adults with acute uncomplicated respiratory infections, a delayed-prescription strategy (ie, prescribing an antibiotic with instructions to start the medication only if symptoms get worse) may lead to significantly decreased use of antibiotics, without any clinically significant increase in the duration of severe symptoms compared to patients given immediate antibiotic treatment.

http://www.ncbi.nlm.nih.gov/m/pubmed/26719947/

Strength of Recommendation = B

Nasal Foreign Bodies: A Sweet Experiment. — December 11, 2015

Nasal Foreign Bodies: A Sweet Experiment.

Summary: When a child has placed a foreign body in the nose, if it can be confirmed from history that the foreign body is a candy (and not a potentially dangerous inorganic or corrosive object), then a “wait and see” approach may be reasonable, since most such candies will dissolve in less than an hour.

http://www.ncbi.nlm.nih.gov/m/pubmed/25639608/

Strength of Recommendation = C

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