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NICE Guidance - September 2020

The National Institute for Health and Care Excellence (NICE) have published new or updated guidance for the month of September 2020. This month there are three guidelines, one technology appraisal and one antimicrobial guideline that impact upon primary care.

The Low back pain and sciatica in over 16s: assessment and management guideline has been updated. It covers assessing and managing low back pain and sciatica in people aged 16 and over. This updated adds several recommendations on the pharmacological management of sciatica including not using gabapentinoids, other antiepileptics, oral corticosteroids or benzodiazepines and not using opioids in chronic sciatica. Reference is made to a guideline in development on medicines associated with dependence or withdrawal symptoms: safe prescribing and withdrawal management which is due for publication next year.

The Neuropathic pain in adults: pharmacological management in non-specialist settings guideline has been updated. It covers managing neuropathic pain with pharmacological treatments in adults in non-specialist settings. The evidence on treating sciatica has been reviewed and new recommendations on pharmacological treatment have been added in line with the guideline above.

The Suspected cancer: recognition and referral guideline has been updated. It covers identifying children, young people and adults with symptoms that could be caused by cancer. The update clarifies when to offer faecal testing for colorectal cancer to adults without rectal bleeding.

The Insect bites and stings: antimicrobial prescribing antimicrobial prescribing guideline has been published. It sets out an antimicrobial prescribing strategy for insect and spider bites and stings in adults, young people and children aged 72 hours and over, including those that occurred while travelling outside the UK. It aims to limit antibiotic use and reduce antibiotic resistance.

The Naldemedine for treating opioid-induced constipation technology appraisal has been published. It recommends naldemedine, within its marketing authorisation, as an option for treating opioid-induced constipation in adults who have had laxative treatment.

Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.