GPEAs update 2016

Please find below a list of all GPEA projects to date, with PICOS, bottom lines and powerpoint attachments for those presented in 2016  – see previous post for more detail on 2015 GPEAs.

GPEAS in 2015

  • Oral v Topical Antibiotics for Otitis Externa
  • Olive Oil v Alternative topical treatments for Ear Wax
  • Topical antibiotics+steroid v Topical antibiotics alone for Otitis Externa
  • Chloramphenical v Placebo for Infective Conjunctivitis

GPEAS in 2016

Are triptans safe in pregnancy?

Abisola Seriki and Melissa Bonar

P = Pregnant women with typical migraine aged 18-40
I = Triptans
C = No medications or prophylaxis
O = Control of symptoms to be able to function

Clinical bottom line:

Consider use of a triptan after discussing need for treatment. Sumatriptan is the preferred triptan in pregnancy.

NSAID use in chicken pox

James Harper, Chris Phillips, Tom Hutchinson

P = Paediatric patients with varicella zoster
I = Use of NSAIDs
C = Use of placebo/avoidance of NSAIDs
O = Development of secondary streptococcal skin infections

Clinical bottom line:

  • Underlying mechanism exists to suggest NSAIDs decrease neutrophil function
  • Studies demonstrate an association between NSAID use in chickenpox and subsequent skin infections but not a causation.
  • Case for paracetamol as first line in chickenpox
  • Not enough to say avoid NSAIDS

Chicken pox [ppt]

Topical or oral treatment for vulvovagin acandidiasis

Helen Reay & Kate Shipton

P: Women with vulvovaginal candidiasis
I: Oral Fluconazole
C: Topical Clotrimazole (Pessary ± Cream)
O: Resolution of symptoms

Clinical bottom line:

  • Clinical outcomes not significantly different
  • Therefore cost and patient choice will influence prescribing practice

Vulvovaginal Candidiasis

Should we prescribe antibiotics for sore throat?

Gerald Clancy, Alice Young and Selina Soukup

P = Sore throat in adults and children
I = antibiotic therapy
C = no antibiotics/supportive therapy only
O =

  • Primary – Duration of symptoms
  • Secondary – Suppurative complication (otitis media within 14 days, acute sinusitus within 14 days, quinsy within 2 months)

Clinical bottom line:

Antibiotics shorten duration of symptoms by about 16 hours overall.