Primary Care Commons^™

Hepatitis C Screening, Stanley Hunter Md

Family Medicine Scholarly Works

Clinical Question: Does screening baby boomers for Hepatitis C decrease mortality and/or save money?

Bottom Line Answer: Age-based screening for hepatitis C is cost effective ($4900 per QALY gained) for those born between 1945 and 1965.

Lyme Disease Prophylaxis: Idsa Guidelines, Kristine Cruz Md

Family Medicine Scholarly Works

Clinical Question: When should patients be given antibiotics for lyme prophylaxis after a tick bite?

Bottom Line Answer: To provide antibiotic prophylaxis for Lyme disease ALL of these criteria should be met:

• Tick identified as an adult or nymphal deer tick
• Attached for > or = 36 hours (by engorgement or time of exposure)
• Treatment started within 72 hours of tick removal
• Local rate of infection of ticks with B. Bourgdorferi >=20% (assumed in Vermont)
• Doxyclycline is not contraindicated

Antibiotics In Suspected Infectious Diarrhea, John G. King Md, Mph

Family Medicine Scholarly Works

Clinical Question: When should antibiotics be given for suspected infectious diarrhea?

Bottom line answer: Antibiotics has been shown to be beneficial in the following groups based on randomized clinical trials (SORT A):

• Moderate to severe traveler’s diarrhea (more than four unformed stools, fever, blood, pus or mucus in the stool).
• More than eight stools per day, dehydration, symptoms of more than one week, and those in which hospitalization is considered.
• Avoid antibiotics in some infections (bloody diarrhea and abdominal pain, but little or no fever – consistent with possible STEC infection). Empiric treatment:
• Oral fluoroquinolone (ciprofloxacin, oflaxacin, levofloxicin) for 3-5 …