General internist, health services and clinical researcher | Health, education, infrastructure, opportunity for all Americans | Bicycles | Opinions, own
Jeff Linder
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The intervention group got amox/clav bid for 90 DAYS.
Only 8/85 (9%) got diarrhea? 🤔
This may be my "favorite" result from the study.
Despite multiplex respiratory point-of-care testing changing WHICH patients got antibiotics -- in the testing arm, patients with an identified virus were less likely to get abx -- there was no difference in improvement in symptom severity.
Jeff Linder
For a change, I am being a good spaced learner and have almost finished relistening to this @thecurbsiders.bsky.social episode with @jordybc.bsky.social.
But a question...
thecurbsiders.com/curbsiders-p...
This raises the possibility that maybe, just maybe, antibiotics don't change outcomes for patients with respiratory infections in primary or urgent care.
Julie Szymczak and I wrote more here:
bsky.app/profile/jeff...
For home blood pressure monitoring, asking patients to get 2 blood pressures twice a day for 7 days for a total of 28 readings, seems perfectly designed to make it not get done at all.
I ask patients to do 1 blood pressure, morning and night for 3 days.
@paulnwilliams.bsky.social
For those 6 blood pressures -- just 6! -- I give them the AHA HBPM instructions and a link to validatebp.com.
Is there really that much of a marginal gain of asking patients to get 28 blood pessures over 7 days versus 6 readings over 3 days?
Happy to give up precision for ease and feasibility.
SAY WHAT NOW?!
@jamanetworkopen.com published a study of what?!
Did I miss something over the last 30 years about there being equipoise in the use of antibiotics for <rereads paper title> low back pain!??
jamanetwork.com/journals/jam...
Jeff Linder
Use of a rapid microbiological point-of-care test for respiratory infections did not lead to an expected overall reduction in same-day antibiotic prescribing in #PrimaryCare.
Results of the RAPID-TEST clinical trial published in @jamainternalmed.com.
👉 Read the news: tinyurl.com/y3x3hv29
@jefflinder.bsky.social & Julie Szymczak comment on the results of the RAPID-TEST clinical trial led by Alastair Hay in this related @jamainternalmed.com editorial.
For the trial results, see: tinyurl.com/5f8vv3m9
#AMR #Antibiotics #AntimicrobialResistance #PrimaryCare #GPSky #PharmSky
Jeff Linder
This randomized clinical trial examines whether amoxicillin-clavulanate is effective in a subgroup of individuals who have chronic low back pain with disc herniation and bone changes detected on magne...
For antibiotic overuse, I've heard for YEARS about how we just need better tests.
But it's not that simple.
Julie Szymczak and I have a new editorial in @jamainternalmed.com on modern microbiological testing failing to reduce antibiotic prescribing.
jamanetwork.com/journals/jam...
A randomized trial found that rapid multiplex respiratory point-of-care testing did not reduce same-day antibiotic prescribing or worsen symptom severity for patients with respiratory infections in primary care. ja.ma/4frUOSL
For antibiotic overuse, I've heard for YEARS about how we just need better tests.
But it's not that simple.
Julie Szymczak and I have a new editorial in @jamainternalmed.com on modern microbiological testing failing to reduce antibiotic prescribing.
jamanetwork.com/journals/jam...
