» Vaccine-preventable infections

Corticosteroids for dengue infection

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There is insufficient evidence to justify the use of corticosteroids in managing dengue shock syndrome. As corticosteroids can potentially do harm, clinicians should not use them unless they are participating in a randomized controlled trial comparing corticosteroids with placebo.
Dengue virus is …

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Vaccines for preventing typhoid fever

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The licensed Ty21a and Vi polysaccharide vaccines are efficacious in adults and children older than two years in endemic countries. The Vi-rEPA vaccine (which has not been commercialised) is just as efficacious, although data is only available for children. The new …

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Fluoroquinolones for treating typhoid and paratyphoid fever (enteric fever)

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Trials were small and methodological quality varied. In adults, fluoroquinolones may be better for reducing clinical relapse rates compared to chloramphenicol. Data are limited for other comparisons, particularly in children.
Fluoroquinolones are recommended as first-line therapy for typhoid and paratyphoid fever (enteric …

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Vaccines for preventing invasive salmonella infections in people with sickle cell disease

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It is expected that salmonella vaccines may be useful in people with sickle cell disease, especially in resource-poor settings where the majority of those who suffer from the condition are found. Unfortunately, there are no randomized controlled trials on the efficacy …

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Immunoglobulins for preventing hepatitis A

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Immunoglobulins seem effective for preventing hepatitis A in both children and adults. However, the evidence, on which the conclusion is based, is not strong as the included trials appear to have risk of bias and their number is insufficient.
Hepatitis A is …

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Vaccines for preventing cholera: killed whole cell or other subunit vaccines (injected)

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Injected cholera vaccines appear to be safe and relatively more effective than usually realized. Protection against cholera persists for up to two years following a single dose of vaccine, and for three years with an annual booster. However, they have been …

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Oral rehydration salt solution for treating cholera: ≤ 270 mOsm/L solutions vs ≥ 310 mOsm/L solutions

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In people with cholera, ORS ≤ 270 is associated with biochemical hyponatraemia when compared with ORS ≥ 310 [90 mmol/L of sodium, 20 mmol/L of potassium, 80 mmol/L of chloride, 10 mmol/L of citrate, and 111 mmol/L of glucose, with a …

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Polymer-based oral rehydration solution for treating acute watery diarrhoea

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Polymer-based ORS shows some advantages compared to ORS ≥ 310 [the original ORS was based on glucose and had an osmolarity of ≥ 310 mOsm/L] for treating all-cause diarrhoea, and in diarrhoea caused by cholera. Comparisons favoured the polymer-based ORS over …

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Xpert® MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults

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Xpert® MTB/RIF used as initial diagnostic test for TB detection in patients suspected of having TB, MDR-TR or HIV-associated TB is sensitive and specific. Compared with smear microscopy, Xpert® MTB/RIF substantially increases TB detection among culture-confirmed cases. Xpert® MTB/RIF may also …

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Colloids versus crystalloids for fluid resuscitation in critically ill patients

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There is no evidence that resuscitation with colloids reduces the risk of death, compared to resuscitation with crystalloids, in patients with trauma, burns or following surgery. Furthermore, the use of hydroxyethyl starch might increase mortality. As colloids are not associated with …

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