New evidence on antibiotics for exacerbations of chronic obstructive pulmonary disease – with some bits missing

Key message: Giving antibiotics to people admitted to the Intensive Care Unit (ICU) with severe exacerbations of COPD showed large and consistent benefits. Evidence relating to the use of antibiotics for people with moderate or mild exacerbations is inconsistent and there is continued uncertainty about whether antibiotics benefit those who can be treated as outpatients. 

Children living with pain may be helped by psychological therapies

Key message: Psychological therapies can be helpful in reducing pain in childen and adolescents with chronic and recurrent pain. 

Living with chronic pain is a miserable business. It can be a major cause of disability and distress and affects not only the person themselves but those close to them. Any parent will tell you how upsetting it is to see their child in pain and I was surprised to learn how many children live with it, around 15% to 30%, with around 8% having severe and frequent pain. So what can be done to help them?

Topical steroids helpful in managing chronic rhinosinusitis and nasal polyps

Key message: Topical steroids are a beneficial treatment for chronic rhinosinusitis with nasal polyps and the adverse effects are minor, with benefits outweighing the risks.

Treating acute asthma in the emergency department: the latest evidence

Key message: Inhaled corticosteroid therapy (ICS) reduces hospital admissions in patients with acute asthma who are not treated with oral or intravenous corticosteroids. It is unclear whether ICS reduces admissions in those given systemic corticosteroids and whether it could be used in place of systemic corticosteroids. 

Managing asthma: how does taking inhaled corticosteroids only when symptoms get worse compare with daily use?

Key message: intermittent and daily use of inhaled corticosteroids by adults and children with persistent asthma did not significantly differ in the use of rescue oral corticosteroids and the rate of adverse events. Clinicians and patients should carefully weigh up the potential benefits and harms of each treatment option.