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Published on: June 29, 2019

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[2013 literature findings in internal general medicine]

Francis Vu, Olivier Pasche, Christine Arnold

    Revue Medicale Suisse
    |March 15, 2014
    PubMed

    Insights

    Antibiotic treatment for skin abscesses and diverticulitis offers no benefit and may increase infection risk. Age-adjusted D-dimer testing improves accuracy for diagnosing conditions like deep vein thrombosis.

    Area of Science:

    • Internal Medicine
    • Clinical Practice Guidelines
    • Evidence-Based Medicine

    Context:

    • Antibiotic stewardship is crucial to prevent resistance and Clostridium difficile infections.
    • Diagnostic accuracy for conditions like deep vein thrombosis can be improved with adjusted testing thresholds.
    • Patient anxiety management requires effective strategies beyond diagnostic testing.

    Purpose:

    • To evaluate the efficacy of antibiotics for uncomplicated skin abscesses and diverticulitis.
    • To assess the safety and utility of penicillin allergy exclusion tests.
    • To determine the optimal treatment for sleep apnea syndrome and the role of diagnostic tests in managing patient anxiety.
    • To explore the impact of advanced practice nurses and hospital work hour limitations on primary care and patient access.

    Summary:

    • Antibiotics provide no benefit for uncomplicated skin abscesses and diverticulitis and increase Clostridium difficile risk.
    • Penicillin allergy testing is safe. Age-adjusted D-dimer testing enhances diagnostic specificity without compromising sensitivity.
    • Continuous positive airway pressure (CPAP) is more beneficial than mandibular advancement for sleep apnea.
    • Prescribing paraclinical tests does not alleviate patient anxiety. Advanced practice nurses can support primary care physicians.

    Impact:

    • Promotes judicious antibiotic use, reducing risks and healthcare costs.
    • Enhances diagnostic precision, leading to more appropriate patient management.
    • Optimizes treatment strategies for sleep apnea and anxiety, improving patient outcomes.
    • Highlights the need for supportive roles in primary care and addresses challenges in hospital physician work hour regulations.

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