Wednesday, September 06, 2006
OSN SuperSite - Delayed antibiotic prescription may be best strategy for conjunctivitis
Delayed prescribing — giving a prescription that can be picked up at patients discretion 3 days after the initial office visit — reduced antibiotic use by 50% and provided a level of symptom relief similar to immediate prescribing, according to this study.
"Our [previous] qualitative research showed patients were happy with delayed prescribing and were comfortable about deciding whether to start antibiotics," said Hazel A. Everitt and colleagues in the study, published in the BMJ.
Ms. Everitt and colleagues randomly assigned patients with infective conjunctivitis to three treatment groups; 104 patients received immediate treatment with topical antibiotics, 109 patients received a prescription that could be picked up after 3 days, and 94 patients received no antibiotics. The researchers found only 53% of the delayed treatment group chose to use the drugs.
Antibiotic use did not affect symptom severity, but it did lessen the duration of moderate symptoms: 4.8 days for untreated patients, 3.9 days for delayed treatment patients and 3.3 days for immediate treatment patients.
"Is it worth prescribing immediate antibiotics when the benefit is likely to be a half day's worth reduction in moderate symptoms?" researchers asked.
The study is published in the August issue of the British Journal of Medicine.
Effects of presentation method on the understanding of informed consent -- Moseley et al. 90 (8): 990 -- British Journal of Ophthalmology
Adapted from the abstract:
This study found differences in the participants’ ability to recall facts based on the manner in which the material was presented. It clearly demonstrated that the use of visual aids improved the ability to remember facts and risks associated with cataract surgery beyond a verbal presentation alone. It also showed a benefit of the repetition of information as provided by audiovisual presentations that can be used in conjunction with the physician-patient discussion.
ScienceDirect - Journal of American Association for Pediatric Ophthalmology and Strabismus : Tinted Contact Lenses as an Alternative Management for Photophobia in Stationary Cone Dystrophies in Children
The following is adapted from the abstract:
Intense photophobia is a debilitating symptom of the stationary cone dystrophies. The dark-tinted glasses with side-shields and floppy hats used to manage this can cause marked psychological morbidity to the children and their families. Three children with cone dystrophies were fitted with Lunelle ES70 Solaire 70% brown contact lenses. Two of the children and their parents described a striking improvement in their quality of life, with improved confidence, interactions with other children, and cessation of name-calling and bullying. The third child was reluctant to wear the contact lenses despite her parents’ active encouragement.
Conclusion: Tinted contact lenses offer an alternative management of the photophobia associated with stationary cone dystrophies in children. Marked improvements in their quality of life were observed in this case series.