Journal of Urgent Care Medicine

FDA Keeping Tabs on Montelukast Suicide Risk

The Food and Drug Administration (FDA) presented the preliminary results of new research on montelukast at the American College of Toxicology meeting recently, describing potential side-effect risks for the oral asthma drug. Montelukast may be leading to mental health conditions and suicide by attaching to multiple brain receptors that are involved in psychiatric functioning, researchers say. According to Reuters, thousands of patients have reported neuropsychiatric episodes, prompting the FDA to launch a comprehensive investigation and …

AAP Offers Guidelines for Pediatric Opioid Prescribing

The American Academy of Pediatrics (AAP) has issued its first clinical practice guideline on prescribing opioids for outpatient acute pain management in children, published in Pediatrics. The guideline recommends using immediate-release opioids at the lowest dose for age- and weight-appropriateness, with an initial supply of no more than 5 days unless the pain is due to trauma or surgery requiring longer treatment. Codeine and tramadol should not be prescribed to children under 12, adolescents with …

Amoxicillin-Clavulanate Shows Slightly More Risk of Issues Than Amoxicillin

In a study of 320,141 children published in JAMA Network, researchers found those treated with amoxicillin-clavulanate had a slightly higher risk of treatment failure (defined as lack of effectiveness or intolerability) compared with amoxicillin. And for those treated with amoxicillin-clavulanate, there was also a higher risk of gastrointestinal symptoms and yeast infections. Accessing treatment in urgent care was more common among patients who received amoxicillin-clavulanate (9.6%) than those who received amoxicillin (5.9%), and urgent care …

About 5% of Adults With RSV Experience Hospitalizations

Researchers quantified the real-world risk for hospitalization among adults diagnosed with respiratory syncytial virus (RSV) in outpatient settings in a study presented in JAMA Network Open. They examined all-cause 28-day hospitalization following outpatient RSV infections among all adults as well as a high-risk subgroup of adults across 6 RSV seasons comprising 67,239 outpatient infections. Data revealed approximately 5% of adults experienced all-cause hospitalization within 28 days following outpatient RSV infections. The analysis showed an absolute …

Twice as Many Moms Diagnosed With Postpartum Depression

Rates of postpartum depression (PPD) have doubled over the last decade, according to a Kaiser Permanente cross-sectional study of 442,308 births from 2010 to 2021, presented in JAMA Network Open. The rate of diagnosis jumped from about 9% to 19% in 2021 (P for trend <.001). In the study, 83.7% of subjects had initiated prenatal care during the first trimester, and authors note that in spite of better screening tools and clinician awareness, PPD continues to be …

Heart Disease Deaths Related To Obesity Climbing 5% Annually

According to new research from the American Heart Association, heart disease deaths related to obesity increased by 180% in the U.S. between 1999 and 2020. Findings were especially concerning among men (increased 243%) and more specifically, middle-aged men (increased 165%). Also, Black adults exhibited heart disease death rates related to obesity of 3.93 deaths per 100,000 people. Researchers measured age-adjusted mortality rates and found a 5.03 annual percentage increase in the overall rate of obesity-related …

Caffeine-Related ED Visits Double for Teens and Tweens

Caffeinated drinks seem to have become a lifestyle for American teens and tweens. A recent study from Epic Research showed that emergency department (ED) visits connected to consuming excessive amounts of caffeine nearly doubled among some age groups from 2017 to 2023. For kids ages 15 to 18, the rate increased from 7.4 per 100,000 visits in 2017 to 13.6 per 100,000 visits in 2023. But for kids ages 11 to 14, visits related to …

Mycoplasma Pneumoniae Infections Rising Among Children

Just as urgent care centers across the nation prepare for peak flu season, the Centers for Disease Control and Prevention (CDC) is also taking note of a rise in Mycoplasma pneumonia cases that’s been going on for the past 6 months. The analysis is based on data from patients discharged from emergency departments with a diagnosis of Mycoplasma pneumonia-associated pneumonia or acute bronchitis. According to the agency, there was a peak in August of this …

Cranberry Juice Helps Kids With Recurrent UTI

Preventing recurrent urinary tract infection (RUTI) in children usually involves antibiotic prophylaxis. A new meta-analysis in Pediatrics of 23 randomized controlled trials found that for children with a history of RUTI, the antibiotic nitrofurantoin and cranberry products— both cranberry juice and tablets as supplementation—appeared to decrease the incidence of symptomatic episodes. Nitrofurantoin significantly lowering odds of symptomatic UTI episodes during prophylaxis, whether compared with controls (odds ratio [OR] 0.21, 95% confidence interval [CI] 0.07-0.65, P=0.007) …

Consider Patient Environment And Critter Infestations That May Cause Pruritus

Scabies, bedbugs, and body lice commonly cause pruritus and rash, and accurate diagnosis of the symptoms should include consideration for social drivers of health, such as housing status and living environment, according to a recent literature review presented in JAMA. It’s concerning because pruritus may persist after scabies treatment—largely due to misdiagnosis and inadequate treatment—and persistent scratching can present a risk for skin infection. While bedbug bites usually resolve after 1 week without treatment, professional …