New Interventional procedures guidance [IPG616] Intranasal phototherapy for allergic rhinitis

New Interventional procedures guidance [IPG616] Intranasal phototherapy for allergic rhinitis
Published date: June 2018  Next review: June 2021


Evidence-based recommendations on intranasal phototherapy for allergic rhinitis in adults. This involves using light to reduce inflammation inside the nose.
 For full guidance https://www.nice.org.uk/guidance/ipg616

Enhancing antibiotic stewardship by tackling “spurious” penicillin allergy

Clin Exp Allergy. 2017;47:1362–1373. https://doi.org/10.1111/cea.13044

Approximately 90-99% of patients with a label of penicillin allergy (PenA) are not allergic when comprehensively investigated. An inaccurate label of PenA has major public health implications—longer hospital stay, more frequent hospital admissions, greater use of fluoroquinolones, glycopeptides, cephalosporins and other expensive antibiotics resulting in significantly higher costs to the health service and predisposing to Clostridium difficile, methicillin-resistant Staphylococcus aureus infections and vancomycin-resistant enterococcus. We describe lessons learnt from recent studies regarding possible reasons contributing to an inaccurate label of PenA as well as propose a concerted multidisciplinary approach to address this important public health problem. Given the unmet need for allergy services in the UK and several other countries and knowledge gaps regarding PenA amongst healthcare professionals, we describe the potential role for a computerized clinical decision support system to enable non-specialists rapidly identify and de-label “low-risk” hospitalized patients with a label of PenA thereby obviating the need for allergy tests. This approach however needs rigorous evaluation for feasibility, safety, patient and physician acceptability, cost-effectiveness and its compatibility with information technology systems currently employed in the health service.

UHCW Research: M. Li

‘Vaginal seeding’ birth trend could do more harm than good, say experts

The potential benefits of vaginal seeding do not outweigh the risks, according to a group of doctors who reviewed the available evidence published in BJOG: An International Journal of Obstetrics and Gynaecology.

Vaginal seeding is the practice of exposing babies born by caesarean section to their mother’s vaginal fluids in order to expose them to bacteria that may help to build their immunity against some chronic conditions, such as asthma and allergies. This involves taking a swab of vaginal fluid and applying it to the baby’s eyes, face and skin after birth.

Infant formulas containing hydrolysed protein for prevention of allergic disease and food allergy

Allergy is common and may be associated with foods, including cow's milk formula (CMF). Formulas containing hydrolysed proteins have been used to treat infants with allergy. However, it is unclear whether hydrolysed formulas can be advocated for prevention of allergy in infants.

To compare effects on allergy and food allergy when infants are fed a hydrolysed formula versus CMF or human breast milk. If hydrolysed formulas are effective, to determine what type of hydrolysed formula is most effective, including extensively or partially hydrolysed formula (EHF/PHF). To determine which infants at low or high risk of allergy and which infants receiving early, short-term or prolonged formula feeding may benefit from hydrolysed formulas.

Some babies should be given peanuts early say new US guidelines

The new US guidelines, which are informed by expert panel discussions and a new UK study, suggest that if an infant has severe eczema or an egg allergy, peanuts may be introduced at around four to six months. And that waiting later may increase the risk of an allergy developing.

However, they suggest checking with a health professional first if the infant does have these severe allergies.

Infant diets that include egg or peanut products appear to reduce food allergies

Certain allergenic foods introduced to an infant’s diet while weaning appear to reduce the chance of developing food allergies. This high quality review, including studies published this year, suggests that historical recommendations to delay the introduction of peanut and other allergenic foods to infant child’s diet in the first year of life may have been mistaken.

From the NIHR Dissemination Centre