Antibiotics are among the most frequently prescribed classes of drugs and it is estimated that approximately 50% of antibiotic use, in both the outpatient and inpatient settings, is inappropriate. At the same time, in contrast to any other class of drugs, every antibiotic use has a potential public ...health consequence – inappropriate use may not harm only the individual patient, but contributes to societal harm by exerting an unnecessary selective pressure that may lead to antibiotic resistance among bacteria. This video based course will introduce learners to the basic principles of appropriate antibiotic use, demonstrate how to apply these principles to the management of common infections, and outline how to develop and maintain an antimicrobial stewardship program. We will offer a number of illustrative cases, recognizable to the practicing physician in his or her practice to engage learners in the thought processes that lead to optimal decision making, improved outcomes of individual patients, and harm reduction vis-a-vis the bacterial ecology.
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The consolidated guidelines are complemented by an operational handbook which is designed to assist with implementation of the WHO recommendations by Member States, technical partners and others who are involved in the management of patients with DR-TB. The WHO Operational Handbook on Tuberculosis, ...Module 4: Treatment - Drug-Resistant Tuberculosis Treatment provides practical guidance on how to put in place the recommendations at the scale needed to achieve national and global impact.
The operational handbook provides practical information and tools that complement the recommendations in the guidelines. The strategies described in the operational handbook are based on the latest WHO recommendations which were formulated by Guideline Development Groups using the GRADE approach. In many cases however, the recommendations in their current form lacked sufficient clinical and programmatic detail, which is important for implementation. This operational handbook complements the guidelines with practical advice based on best practices and knowledge from the fields such as pharmacokinetics, pharmacodynamics, microbiology, pharmacovigilance and clinical and programmatic management.
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People Who Inject Drugs
In addition, the following individuals of our external expert advisory committee made instrumental contributions to the initial design and content of the document: Billy Pick, USAID; Daniel Wolfe, Open Society Foundations; Dave Burrows, AIDS Projects Management Group; Fabi...enne Hariga, United Nations Office on Drugs and Crime; Mauro Guarinieri, the Global Fund to Fight AIDS, Tuberculosis and Malaria; Richard Needle, Office of the U.S. Global AIDS Coordinator; and Sergey Votyagov, EHRN.
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The pamphlet "Prescription Benzodiazepines" explains the uses, effects, and risks of benzodiazepines, commonly prescribed for insomnia, anxiety, and panic attacks. It describes how these drugs enhance GABA activity to suppress brain activity, leading to short-term effects like drowsiness and anxiety... relief, but also potential long-term risks such as dependence, addiction, and withdrawal symptoms. The pamphlet highlights abuse methods, including combining benzodiazepines with other substances, which increases the risk of overdose, and emphasizes the importance of medical supervision for withdrawal management.
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The consolidated guidelines are complemented by an operational handbook which is designed to assist with implementation of the WHO recommendations by Member States, technical partners and others who are involved in the management of patients with DR-TB. The WHO Operational Handbook on Tuberculosis, ...Module 4: Treatment - Drug-Resistant Tuberculosis Treatment provides practical guidance on how to put in place the recommendations at the scale needed to achieve national and global impact.
The document provides information on different aspects of care and support for TB patients. In particular, the handbook provides practical guidance on the implementation of the interventions that enable treatment adherence such as social support, treatment administration options, digital adherence technologies. The practical guidance also includes models of care for all TB patients, models of care for children and adolescents, integrated care for TB, HIV and comorbidities, engagement of private sector, managing of TB in health emergencies. This new practical handbook also includes two important chapters on health education and counselling, and palliative care for patients with TB.
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The resources provide both the older as well as the updated Operational Guidelines for antiretroviral therapy centres, including administrative issues, functions and establishment of centres, reporting and recording tools, measures to improve retention in HIV care, supply chain management of drugs a...nd various other aspects that are essential to ensure quality treatment for people living with HIV/AIDS.
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The Global Programme on Tuberculosis & Lung Health of the World Health Organization (WHO/GTB) is now combining all current recommendations into one overall set of consolidated guidelines on TB. The guidelines contain recommendations pertaining to all areas related to the programmatic management of T...B (e.g. screening, preventive treatment, diagnostics, patient support, and the treatment of drug-susceptible TB and DR-TB). The consolidated guidelines contain modules specific to each programmatic area.
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This is a pocket-sized manual for use by doctors, senior nurses and other senior health workers who are responsible for the care of young children at the first referral level in developing countries. It presents up-to-date clinical guidelines which are based on a review of the available published ev...idence by subject experts, for both inpatient and outpatient care in small hospitals where basic laboratory facilities and essential drugs and inexpensive medicines are available. It focuses on the inpatient management of the major causes of childhood mortality, such as pneumonia, diarrhoea, severe malnutrition, malaria, meningitis, measles, HIV infection and related conditions. It covers neonatal problems and surgical conditions of children which can be managed in small hospitals. This pocket book is part of a series of documents and tools that support the Integrated Management of Childhood Illness (IMCI).
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For 50 patients requiring surgical care in emergency situations assuming 2 operations per patient (100 interventions)
WHO trauma and emergency surgery kit (TESK) aims to provide materials and drugs to meet the needs of 50 patients requiring surgical care in emergency situations, assuming an avera...ge of two operations per patient. This kit is intended for use by health care providers who are trained in appropriate management of emergent surgical issues and are acting within their scope of practise. It is designed for use in areas where basic levels of infrastructure exist. The composition of TESK has recently been revised in collaboration with the International Committee of the Red Cross to meet the dynamic requirements of emergency situations. In general, this kit contains oral and IV medicines including cold chain drugs and medical supplies including renewables and instruments.
WHO TESK is intended to provide the resources needed for surgical procedures in operating theatres. Some of the sub-units may be used for simpler procedures that may occur in other parts of the facility.
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Antibiotic Stewardship (AS) is a coordinated program that promotes the appropriate use of antimicrobials to improve patient outcomes, reduce microbial resistance, and decrease the spread of multi-drug resistant organisms. In clinical settings, stewardship activities focus on measuring and improving ...how antibiotics are prescribed by clinicians and used by patients. Improving antibiotic prescribing involves implementing effective strategies to modify prescribing practices to align them with evidence-based recommendations for diagnosis and management.
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This is an update (third edition) of the BACPR Standards & Core Components and represents current evidence-based best practice and a pragmatic overview of the structure and function of Cardiovascular Prevention and Rehabilitation Programmes (CPRPs) in the UK. The previously described seven standards... have now been reduced to six but without sacrificing any of the key elements and with a greater emphasis placed on measurable clinical outcomes, audit and certification. Similarly, the second edition provided an overview of seven core components felt to be essential for the delivery of quality prevention and rehabilitation, and this too has been reduced to six. The interplay between cardio-protective therapies and medical risk factors is almost impossible to disentangle for the vast majority of patients and even if specific drug therapies are deployed exclusively for risk factor modulation, the indirect effect will also be cardio-protective. Thus, these have been combined into a single core component – medical risk management.
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Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the... patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
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With this quick reference guide, providers can easily recognize diseases and side effects related to climate change, implement appropriate management and provide guidance to exposed populations, provide up-to-date information on the relationship between the adverse effects of certain drugs and the w...orsening of climate-sensitive health conditions, and determine the possible consequences of climate change for health services. This book addresses key meteorological risks, as well as the health conditions which they may influence, grouped by specific clinical areas.
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The World Health Organization's fact sheet on opioid overdose highlights the significant global health issue posed by opioids, which include natural, semi-synthetic, and synthetic compounds used primarily for pain management. Misuse and unsupervised use can lead to dependence and severe health probl...ems. In 2019, approximately 600,000 deaths were attributed to drug use, with nearly 80% related to opioids; about 25% of these were due to overdose. An opioid overdose is characterized by pinpoint pupils, unconsciousness, and breathing difficulties. The fact sheet emphasizes the importance of increasing access to naloxone, an opioid antagonist that can rapidly reverse overdose effects, and advocates for training individuals likely to witness an overdose in its administration. It also underscores the need for comprehensive strategies, including preventive measures, treatment for opioid dependence, and policies to reduce opioid availability.
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The Zithromax® Supply Chain Assessment Tool is designed to guide assessment team members through a series of interviews
with key informants and to establish inspection procedures when conducting logistics field assessments. The protocol allows
the assessment team to examine the readiness of the N...ational Trachoma Control Program and the District- level health
management structures to receive, manage, distribute and administer donated Zithromax® for mass drug administrati
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The Zithromax® Supply Chain Assessment Tool is designed to guide assessment team members through a series of interviews
with key informants and to establish inspection procedures when conducting logistics field assessments. The protocol allows
the assessment team to examine the readiness of the N...ational Trachoma Control Program and the District- level health
management structures to receive, manage, distribute and administer donated Zithromax® for mass drug administrati
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The third edition, released in 2018, has grown to include a total of 18 chapters, contributed by 20 experts and authors from many countries. The goal remains the same: to educate primary care providers on the best practices in TB diagnosis, treatment and follow-up. All articles are richly illustrate...d, and most include quizzes and CME questions for self learning. The 3rd edition includes new chapters on MDR-TB, adverse effects of TB drugs, adherence monitoring strategies, and nutritional support. There is also content on how to manage children with TB, care for patients co-infected with TB and HIV, how to read and interpret chest x-rays, and how to avoid common pitfalls in TB management.
To download book chapters or the whole book go to the website: http://www.letstalktb.org/download/
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Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, with airway reversibility. Management of chronic inflammation with anti-asthma medication improves asthma control and quality of life. The aim of this journal is to provide an eviden...ce-based approach for chronic asthma management in young children and adolescents and provide guidance on the use of new asthma drugs in children.
For that, the South African Childhood Asthma Working Group (SACAWG) convened in January 2017. The asthma treatment task group reviewed the available scientific literature and international asthma treatment guidelines. The evidence was then graded according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system and recommendations were made based on scientific evidence and local context. Asthma management recommendations were made for children ˂6 years of age and older children and adolescents, as well as for stepping up and stepping down of therapy. This review does not include biologics or novel asthma drugs, which are covered in another CME article in this edition of SAMJ.
The final conclusions are that it is important to ensure good response, treatment and adherence, type of medication, device and checking of technique are all critical. Stepping up of therapy should be done only after ensuring good adherence and technique. Once therapeutic response is achieved, medication administration has to be stepped down to improve ease of use and avoid unnecessary side-effects.
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The Practical manual on laboratory strengthening, 2022 update provides practical guidance on implementation of WHO recommendations and best practices for TB laboratory strengthening. It is an updated version of the GLI Practical Guide to Laboratory Strengthening published in 2017 and provides the la...test practical guidance on use of newly recommended diagnostics as well as guidance in key technical areas, including quality assurance and quality management systems, specimen collection and registration, procurement and supply-chain management, diagnostic connectivity, biosafety, data management, human resources, strategic planning, and model algorithms. The key changes are:
inclusion of recent or updated WHO recommendations for tests to diagnose TB and detect drug resistance;
alignment with the latest WHO critical concentrations for phenotypic drug-susceptibility testing (DST) and the new definitions of pre-XDR-TB and XDR-TB;
updated information on building quality-assured TB testing and management capacity using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) approach (Score-TB package1);
updated information on assessing, analysing and optimising TB diagnostic networks; and
updated information on the use of next-generation sequencing (NGS) to detect mutations associated with drug resistance for surveillance purposes.
The document also provides references to resources and tools relevant for work on laboratory strengthening.
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The WHO COVID-19 Essential Supplies Forecasting Tool (ESFT) assists governments, partners, and other stakeholders to forecast the necessary volume of personal protective equipment, diagnostic equipment, consumable medical supplies, biomedical equipment for case management, and essential drugs for su...pportive care and treatment of COVID-19. The tool provides the user with a choice among several epidemiological methods for forecasting COVID-19 cases, including an integration with Imperial College’s Susceptible-Exposed-Infectious-Removed (SEIR) model.
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