Editor's Choice | This Week in BMJ | Press releases



BMJ No 7104 Volume 315

Press Releases Saturday 9 August 1997


Embargoed: 00.01 Hrs 8 August 1997 UK time

Local treatment best for ventilator dependent children
Antibiotic treatment does not help sore throat
Why Britain's Drug Czar must not wage war on drugs

Local treatment best for ventilator dependent children

[Survey of occupancy of paediatric intensive care units by children who are dependent on ventilators]

Children who need long term ventilator treatment for spinal injury or serious lung disease but who are interactive should not remain in intensive care units, says a paper in this week's BMJ.

The authors questioned the medical directors of all 24 paediatric intensive care units in England and Scotland about the numbers of children who still needed mechanical support to breathe after three months. They found that eighteen children were dependent on ventilators in eight units. a total of around 12% of all available beds.

If treatment at home or in a local hospital is not possible, say the authors, facilities such as community rehabilitation centres or hospital-based long term ventilation units should be available. This would not only release beds for emergency paediatric admissions, but also provide a better and more home-like environment for ventilation dependent children who are not in need of emergency care.

Contact:
Dr Robert Tasker

Hospital for Sick Children
London

Tel: 0171 813 8213
Fax: 0171 813 8206

Antibiotic treatment does not help sore throat

[Reattendance and complications in a randomised trial of prescribing strategies for sore throat: the medicalising effect of prescribing antibiotics]

Prescribing antibiotics for sore throat has only marginal benefit and often encourages patients to seek unnecessary medical care in future episodes, says a paper in this week's BMJ.

In a randomised trial of three approaches to sore throat - a 10 day prescription of antibiotics, no antibiotics, and a delayed prescription if the sore throat had not begun to improve after three days - the authors found that, although there was no difference between the three groups in the incidence of complications, those patients who had taken antibiotics were more likely to return to the surgery the next time they had a sore throat.

Consultations for respiratory conditions in British general practice have increased by 14% in 10 years, say the authors. Since the incidence of sore throat does not appear to have changed, factors such as patient expectations and doctors' attitudes may provide an explanation. The author suggests that if GPs want to reduce unnecessary attendance in the future, they should tell patients that the average duration of a sore throat is five days after consultation and that almost 40% of people have a sore throat for longer than this.

Contact:
Dr I Williamson

Aldermoor Health Centre
Southampton University

Tel: 01703 79 7700
Fax: 01703 70 1125

Why Britain's drug czar must not wage war on drugs

[Editorial]

While we should applaud the government in its serious attempt to tackle the growing national and international drug problem, a vote-catching 'battle against drugs' led by the new drug 'czar' would pose grave dangers, says an editorial in this week's BMJ by Professor John Strang, Director of the National Addiction Centre and his colleagues.

What is needed, say the authors, is a move away from the increasing emphasis on the criminal aspect of the problem in favour of improvements in evidence-based treatments, where there is now good evidence of a number of benefits. 'With prisons already bursting with new inmates on remand or sentence for addiction-fuelled crime, it would be criminal negligence to spend yet more on control whilst demand for treatment still far outstrips capacity'.

Three messages should be pinned above the new czar's desk, they say. There should be clarity about the objectives of the new drug strategy, with reduction of damage to individuals and society as the guiding light; a wide review of effective strategy formation, not just in the field of drugs but in such areas as alcohol and tobacco policy; and the pursuit of policies not for their political or professional popularity but according to the quality of evidence of their individual and public benefit.

Contact:
Professor John Strang

National Addiction Centre

Tel: 0171 919 3438 Fax: 0171 919 3426


Embargoed: 00.01 Hrs 8 August 1997 UK time


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