Cochrane for Clinicians

These are summaries of reviews from the Cochrane Library.

Oct 1, 2016 Issue
Selective Serotonin Reuptake Inhibitors for Fibromyalgia
SSRIs may have a small to moderate effect on pain (number needed to treat [NNT] = 10), global improvement (NNT = 7), and depression (NNT = 13) in patients with fibromyalgia, but the quality of evidence is very low because of bias and small studies. SSRIs do not reduce fatigue related to fibromyalgia.

Oct 1, 2016 Issue
Topical Tacrolimus for Eczema
For children and adults with moderate to severe eczema, topical tacrolimus is an effective, albeit costly, alternative to topical corticosteroids. Both tacrolimus strengths (0.03% and 0.1%) are superior to low-potency topical corticosteroids, whereas tacrolimus 0.1% has similar effectiveness to moderate- to high-potency topical corticosteroids. A mild, self-limited, local burning sensation is common with use.

Sep 1, 2016 Issue
Second-Generation H1-Antihistamines for Chronic Spontaneous Urticaria
There is good evidence that second-generation H1-antihistamines are helpful in the short- and intermediate-term suppression of urticaria. Cetirizine (Zyrtec) in a dosage of 10 mg daily is effective at completely suppressing symptoms of chronic spontaneous urticaria (number needed to treat [NNT] = 4).

Aug 1, 2016 Issue
Capsaicin for Nonallergic Rhinitis
Intranasal capsaicin is safe and effective for reducing symptoms of nonallergic rhinitis (number needed to treat = 4; 95% confidence interval [CI], 1 to 22). There is insufficient evidence to compare the effectiveness of capsaicin to other topical or systemic medications.

Aug 1, 2016 Issue
Acetaminophen for the Treatment of Pain in Newborns
Acetaminophen does not significantly reduce pain associated with heel lance, eye examinations, or assisted vaginal births in newborns. Acetaminophen may reduce the total amount of morphine a newborn needs in the first 48 hours following major abdominal or thoracic surgery.

Jul 1, 2016 Issue
Honey for Acute Cough in Children
For patients one to 18 years of age, providing honey for cough symptoms can reduce the frequency and severity of cough, as well as improve sleep for patients and parents, when compared with placebo or no treatment. Honey is no better than dextromethorphan for symptom control.

Jul 1, 2016 Issue
Intermittent Inhaled Corticosteroid Therapy for Mild Persistent Asthma in Children and Adults
Intermittent inhaled corticosteroid therapy reduces the risk of asthma exacerbations in children and adults with mild persistent asthma. Intermittent use appears to be safe in these patients.

Jun 1, 2016 Issue
Topical Antihistamines and Mast Cell Stabilizers for Treating Allergic Conjunctivitis
Topical antihistamines and mast cell stabilizers, either alone or in combination, are safe and effective for reducing the symptoms of seasonal and perennial allergic conjunctivitis.

Jun 1, 2016 Issue
When to Discontinue Antiepileptic Drug Therapy for Patients in Remission
Children with epilepsy should be seizure-free for at least two years before stopping antiepileptic drug therapy, especially those who have partial seizures or a history of abnormal electroencephalography (EEG) results.

May 1, 2016 Issue
Fluoride Varnish for Preventing Dental Caries in Children and Adolescents
Topically applied fluoride varnishes are safe and effective in preventing dental caries in children and adolescents. There is little information about adverse effects or treatment acceptability. Family physicians should consider incorporating fluoride varnish into childhood preventive care visits.

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