Hearing loss and ear wax

This is a new guideline from NICE on managing hearing loss and ear wax, published in June 2018. Exciting? Well, there are a couple of good bits in here, especially given how common a problem this is. Some top tips that were new for me: Consider an urgent referral to ENT for someone of Chinese…
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Otitis Media – when to use antibiotics

This is a new guideline from NICE on when to use antibiotics for otitis media (March 2018). It doesn't change common practice, but I found some of the statistics really helpful for explaining why we prescribe in some groups and not others. There is an excellent patient leaflet explaining things too. Some background info: Most have…
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Sore throat – when to use antibiotics

This is a new guideline from NICE which advises on when to use antibiotics in patients with tonsillitis or sore throat. If you already use a scoring system to help you decide when to prescribe it doesn't change a lot. Take home points: use a scoring system (FeverPAIN or Centor) and prescribe penicillin 500mg QDS…
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Sinusitis treatment down to five days

This is a NICE guideline from a couple of months ago in the use of antibiotics in sinusitis. I must say that this has changed my practice significantly, so well worth a read, especially the background information. Main learning points: 1st line antibiotic is now penicillin. Length of treatment is five days. Only consider antibiotics…
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Vertigo

An elderly patient enters your room appearing unsteady, ‘No, I haven’t had too much to drink, Doc!’. You probably already have a differential diagnosis in your head, labyrinthitis being one of them. But, as this BMJ editorial reminds us, not all vertigo is labyrinthitis (BMJ 2012; 345:e5809). The authors stress that the terms vertigo and…
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