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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

May NICE Guidance

The National Institute of Health and Clinical Excellence has published new guidance for the month of May. There are two new Clinical Guidelines covering Feverish Illness in Children and Secondary Prevention of Myocardial Infarction (MI).

The quick reference guideline for feverish illness in children provides advice for the assessment and management of fever in children under the age of 5. The topics covered include remote assessment, non-paediatric practitioner assessment, antipyretic interventions, a traffic light system for signs and symptoms and a list of symptoms and signs of specific diseases including meningitis, pneumonia and urinary tract infections.

The quick reference guideline for secondary prevention of MI provides a summary of lifestyle advice, cardiac rehabilitation after acute MI, recommendations for drug therapy for recent MI (less than 12 months ago) and less recent history of MI (more than 12 months ago). One of the key areas of change from the draft appears to be the advice about prescribing omega-3-acid ethyl esters. The advice in the full guideline recommends increased dietary intake of omega-3 fatty acids in the first instance. For patients who have had an MI within 3 months and who are not achieving this, supplementation can be considered and continued for up to 4 years. Treatment should not routinely be started in patients who are more than 3 months post-MI. Statins are recommended as the first line intervention for management of lipids, taking into account acquisition costs simvastatin will be the drug of choice.

Action: Clinicians, in both the primary and secondary care settings, who see feverish children or who treat patients for secondary prevention following an MI will find these guidelines to be a useful resource.

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