The National Institute for Health and Care Excellence (NICE) have published new or updated guidance for the month of February 2024. This month there is one guideline thats impacts upon primary care.
The Tuberculosis guideline has been updated. It covers preventing, identifying and managing latent and active tuberculosis (TB) in children, young people and adults. This update has removed family history of TB in the past 5 years from the list of criteria for BCG vaccination in neonates in low-incidence areas in line with national recommendations. It is also noted that antibiotic recommendations are being reviewed following the MHRA drug safety update regarding fluoroquinolone antibiotics.
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.
The Medicines and Healthcare products Regulatory Agency (MHRA) has published Drug Safety Update for February 2024 (PDF).
This issue notifies clinicians that codeine linctus has now been reclassified as a prescription-only medicine (POM), following a public consultation. A recent review identified greater levels of recreational use than the intended use as a cough suppressant. As a risk minimisation measure to protect the health of patients this product will no longer be supplied without a prescription.
This issue also advises clinicians that pseudoephedrine has been very rarely associated with posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS). These conditions present with a sudden severe headache or thunderclap headache, sudden onset of nausea and vomiting, confusion, seizures and/or visual disturbances. Urgent medical attention should be sought if these symptoms occur and patients presenting with these symptoms should be asked about their medication history.
Lastly in this issue is a summary of letters to healthcare professionals in January. These generally related to supply issues and recalls but also include letters sent to appropriate healthcare professionals about revised educational materials for valproate-containing medicines, the dose-dependent increased risk of atrial fibrillation in patients using omega-3-acid ethyl ester medicines as reported in the drug safety update last month and a change to the pump priming advice prior to first use of Tostran® (Testosterone, 2% gel) following a manufacturing change.
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.
During January 2024 Clinical Knowledge Summaries were published or updated in the following areas.
The Spondyloarthritis and psoriatic arthropathy topic is new. The remaining topics have all been reviewed and updated with minor structural and layout changes. The Neck pain - whiplash injury topic has a new section section providing information on prevalence, causes and complications. The Sinusitis topic has updated the classification of chronic sinusitis in line with the European Position Paper on Rhinosinusitis and Nasal Polyps 2020 (EPOS 2020). The Urinary tract infection (lower) - women topic has been updated in line with the UK Health Security Agency (UKHSA) quick reference tool for primary care for diagnosis and urinalysis and the management recommendations of UTI with haematuria have been updated in line with the NICE guideline on suspected cancer.
Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.
