Urgent Updates | August 24

Prescribing Medications for Alcohol Use Disorder: A Qualitative Study of Primary Care Physician Decision Making

Over 29 million Americans have alcohol use disorder (AUD). Though there are effective medications for AUD (MAUD), they are underutilized. Physicians endorsed that it is challenging to prescribe MAUD due to several reasons, including: (1) somewhat negative personal beliefs about medication effectiveness and likelihood of patient adherence; (2) competing demands in primary care that make MAUD a lower priority; and, (3) few positive subjective norms around prescribing. There is a challenging implementation context for MAUD. Full Access: Annals of Family Medicine


The Efficacy and Safety of Metoclopramide In Relieving Acute Migraine Attacks Compared With Other Anti-Migraine Drugs: A Systematic Review And Network Meta-Analysis Of Randomized Controlled Trials

A significant decrease in headache scores was seen with the administration of intravenous (IV) metoclopramide, compared with placebo and sumatriptan, according to the findings of a study published in the journal BMC Neurology.  Sixteen studies were included with a total of 1934 patients: 826 received metoclopramide, 302 received placebo, and 806 received other active drugs. Metoclopramide was effective in reducing headache outcomes even for 24 h. Regarding side effects, metoclopramide showed a lower incidence of mild side effects than pethidine and chlorpromazine and showed a higher incidence of mild side effects than placebo, dexamethasone, and ketorolac. Full Access: BMC Neurology


The Burden of Antimicrobial Resistance in The Americas In 2019: A Cross-Country Systematic Analysis

Antimicrobial resistance (AMR) is an urgent global health challenge and a critical threat to modern health care. Researchers estimated deaths and disability-adjusted life-years (DALYs) attributable to and associated with AMR for 23 bacterial pathogens and 88 pathogen–drug combinations for countries in the WHO Region of the Americas in 2019. They estimated 569,000 deaths (95% UI 406,000–771,000) associated with bacterial AMR and 141,000 deaths (99,900–196,000) attributable to bacterial AMR among the 35 countries. Lower respiratory and thorax infections, as a syndrome, were responsible for the largest fatal burden of AMR in the region. Full Access: The Lancet


Management of Acetaminophen Poisoning in the US and Canada – A Consensus Statement

This qualitative study used an expert-derived consensus according to a modified Delphi process to provide explicit clinical guidance on the assessment, management, and treatment of acetaminophen poisoning. The panel developed guidelines for emergency department management of single or repeated ingestion of acetaminophen. In addition, the panel addressed extended-release formulation, high-risk ingestion, co-ingestion of anticholinergics or opioids, age younger than 6 years, pregnancy, weight greater than 100 kg, and intravenous acetaminophen use. Full Access: JAMA