The British journal of general practice : the journal of the Royal College of General Practitioners
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Randomized Controlled Trial
Longer term outcomes from a randomised trial of prescribing strategies in otitis media.
There are limited data about the longer-term outcomes in acute otitis media (AOM) when comparing the realistic alternatives of immediate prescription of antibiotics and a 'wait and see' or delayed prescribing policy. ⋯ For most children, delayed prescribing is not likely to have adverse longer-term consequences. Children with recurrent AOM are more likely to have poorer outcomes. Secondary analysis should be treated with caution and requires confirmation, but suggests that treating such children with antibiotics immediately may not alter longer-term outcomes.
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Otitis media is the most common reason for children to receive antibiotics, but there is no evidence about the effect of prescribing on reattendance. ⋯ Prescribing antibiotics for AOM probably increased reattendance, but the opposite effect has been noted for glue ear, which suggests a treatment effect of antibiotics in glue ear. Further research is needed to clarify whether this possible benefit is worth the known harms, and if so in which subgroups of children.
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Randomized Controlled Trial
The effect of a programme of organised and supervised peer support on the initiation and duration of breastfeeding: a randomised trial.
Peer support may improve breastfeeding rates but the evidence is inconclusive. Previous studies and reviews recommend trials in different healthcare settings. ⋯ Peer support did not increase breastfeeding in this population by a statistically significant amount.
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GPs decide whether or not to prescribe antibiotics for acute cough. Apart from clinical signs and symptoms, non-medical reasons influence this decision as well. ⋯ Perceived patient demand has a significant, independent and clinically relevant effect on antibiotic prescribing for acute cough with negative findings on the lung auscultation. Practice guidelines and interventions to optimise antibiotic prescribing have to take this effect into account.