Kim Harman

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Importance Acute sore throat poses a significant burden on primary care and is a source of inappropriate antibiotic prescribing. Corticosteroids could be an alternative symptomatic treatment. Objective To assess the clinical effectiveness of oral corticosteroids for acute sore throat in the absence of antibiotics. Design, Setting, and Participants(More)
BACKGROUND It is not clear which young children presenting acutely unwell to primary care should be investigated for urinary tract infection (UTI) and whether or not dipstick testing should be used to inform antibiotic treatment. OBJECTIVES To develop algorithms to accurately identify pre-school children in whom urine should be obtained; assess whether or(More)
PURPOSE Up to 50% of urinary tract infections (UTIs) in young children are missed in primary care. Urine culture is essential for diagnosis, but urine collection is often difficult. Our aim was to derive and internally validate a 2-step clinical rule using (1) symptoms and signs to select children for urine collection; and (2) symptoms, signs, and dipstick(More)
BACKGROUND The prevalence of targeted and serendipitous treatment for, and associated recovery from, urinary tract infection (UTI) in pre-school children is unknown. AIM To determine the frequency and suspicion of UTI in children who are acutely ill, along with details of antibiotic prescribing, its appropriateness, and whether that appropriateness(More)
BACKGROUND In the UK, urinary tract infections (UTIs) are the most common bacterial infection presented by women in primary care. Recurrent urinary tract infections (RUTIs) are defined as three episodes of UTI in the last 12 months, or two episodes in the last 6 months. Between 20 and 30 % of women who have had one episode of UTI will have an RUTI, and(More)
BACKGROUND Antibiotic treatment recommendations based on susceptibility data from routinely submitted urine samples may be biased because of variation in sampling, laboratory procedures and inclusion of repeat samples, leading to uncertainty about empirical treatment. OBJECTIVE To describe and compare susceptibilities of Escherichia coli cultured from(More)
OBJECTIVE To estimate the cost-effectiveness of a two-step clinical rule using symptoms, signs and dipstick testing to guide the diagnosis and antibiotic treatment of urinary tract infection (UTI) in acutely unwell young children presenting to primary care. METHODS Decision analytic model synthesising data from a multicentre, prospective cohort study(More)
Introduction and aims DUTY is a prospective cohort study to derive a clinical algorithm for diagnosis of urinary tract infections in acutely unwell children in primary care. It provides an example of successful recruitment to a complex paediatric study, requiring the collection of a urine sample from young, unwell children. The aim is to describe and(More)
P44 Expectancy did not predict treatment response in a randomised sham-controlled trial of acupuncture for menopausal hot flushes Carolyn Ee, Sharmala Thuraisingam, Marie Pirotta, Simon French, Charlie Xue, Helena Teede 1 National Institute of Complementary Medicine, Western Sydney University, Sydney, Australia; 2 Department of General Practice, University(More)
BACKGROUND The added diagnostic utility of nappy pad urine samples and the proportion that are contaminated is unknown. AIM To develop a clinical prediction rule for the diagnosis of urinary tract infection (UTI) based on sampling using the nappy pad method. DESIGN AND SETTING Acutely unwell children <5 years presenting to 233 UK primary care sites. (More)