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BPJ 44 May 2012

Best Practice Journal

Update on oxycodone: what can primary care do about the problem?

The volume of oxycodone prescribed in New Zealand is continuing to rise, despite efforts to encourage clinicians to use this medicine appropriately. Approximately 30% of oxycodone is initiated within general practice. A further 17% of prescriptions are continued by General Practitioners, when initiated outside general practice. Knowledge of a patient’s clinical and medicines history and psychosocial background puts General Practitioners in a strong position to not simply “go with the flow”, but instead re-evaluate the indication for oxycodone. View Article

Surveillance of people at increased risk of colorectal cancer

The incidence of colorectal cancer in New Zealand is high by international standards. New Zealand females have one of the highest rates in the world (compared to other females). Colorectal cancer occurs less frequently in Māori than in non-Māori, but Māori with colorectal cancer are more likely to die from this disease. Increasing age and a family history are the strongest risk factors for developing colorectal cancer. An assessment of individual risk is required for people at increased risk of colorectal cancer, as well as those with symptoms, and appropriate surveillance and investigation carried out. View Article

Managing urinary tract infections in children

Although relatively uncommon in children, urinary tract infection (UTI) should be considered when assessing a young child with fever or any sign of infection without an obvious source. Older children are more likely to be able to describe specific urinary symptoms. Urinalysis (culture and microscopy) is recommended for all children with suspected UTI. Collecting a urine sample can be difficult, however, there are several methods that may be considered. While UTI is usually simple to treat, if a diagnosis is missed or the infection not adequately managed, there is a significant risk of complications. View Article

The appropriate use of macrolides

Macrolides are a class of antibiotic that includes erythromycin, roxithromycin, azithromycin and clarithromycin. First-line indications for macrolides include the treatment of atypical community acquired pneumonia, H. Pylori (as part of triple therapy), chlamydia and acute non-specific urethritis. Macrolides are also a useful alternative for people with penicillin and cephalosporin allergy. View Article

Upfront: The new face of diabetes care in New Zealand

ON 1 JULY, 2012 the “Get Checked” programme, under which diabetes follow-up care in New Zealand is funded, will be replaced by the “Diabetes Care Improvement Package”. View Article

Correspondence: Albumin:creatinine ratio; HPV vaccination

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