NEJM Journal Watch reviews over 250 scientific and medical journals to present important clinical research findings and insightful commentary
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Bacteria and other pathogens have increasingly developed resistance to antimicrobials. Dr Lauri Hicks from the CDC has dedicated her career to improving antibiotic use. She explains why stewardship is so critical. Learn more about setting up such a programme.
### What you need to know Loop diuretics are commonly prescribed to manage oedema symptoms such as swollen legs or breathlessness and to relieve fluid overload. They are widely recommended by guidelines and organisations such as the National Institute for Health and Care Excellence (NICE) in the UK. The loop diuretics available in the UK are furosemide, bumetanide, and torasemide. But which option is best? The pharmacokinetics of loop diuretics are well characterised. Studies and trials on humans and animals describe pharmacodynamic differences between loop diuretics. However, there is limited evidence directly comparing them. In particular, there is little and low quality information comparing the clinical outcomes of furosemide with the less commonly chosen alternatives torsemide and bumetanide. This article (box 1) outlines some pharmacokinetic differences between available loop diuretics that may influence loop selection in practice and advises how to dose them effectively. Box 1 ### How this article was created We initially wrote this article in response to questions primary care clinicians frequently posed when seeking assistance in managing oedema in patients with heart
Individuals taking a certain number of NSAIDs each month had greater risks of acute kidney injury and chronic kidney disease.
Rethinking How Antibiotics Are Prescribed: Incorporating the 4 Moments of Antibiotic Decision Making Into Clinical Practice. | Infectious Diseases | JAMA | JAMA Network
This Viewpoint summarizes recommendations from the Agency for Healthcare Research and Quality for improving antibiotic use and safety that encourages clinicians to ask if antibiotics are necessary, and to use testing and deliberate judgment to decide which ones, for how long, and if coverage can be…