Breaking the Status Quo: Antimicrobial Stewardship in Diverticulitis & Casting vs. Surgery for Ankle Fractures

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This week on The Rounds Table we are breaking the dogmas in clinical practice to find out if less is more. Does diverticulitis even require antibiotics in the age of antimicrobial stewardship? Next, how does casting compare to surgery for ankle fractures in older adults? Kieran and Lauren Lacroix discuss two thought-provoking new studies:

Diverticulitis is a common diagnosis in the Emergency Department; it can progress to peritonitis, sepsis, and even death. The classical teaching is to treat with antibiotics and monitor for worsening disease. Lauren takes listeners through an trial that challenges this dogma: in patients with acute uncomplicated diverticulitis, is observational treatment non-inferior to treatment with antibiotics?

Next, Kieran switches gears to discuss management of ankle fractures in older adults. Ankle fractures result in loss of independence and reduced quality of life – a high price to pay! Kieran guides listeners through a trial which compared two treatments: surgery (the gold standard) versus close contact casting.

Lastly, the Good Stuff segment. What is the impact of rudeness on medical team performance? And do you ever find yourself mixing up names? Lauren and Kieran share their recent interests on these perplexing questions!

Like what you hear? Rate us on iTunes! Chat with us on Twitter @roundstable and tweet at Kieran directly @kieranlquinn and Lauren @llacroix4.

The Papers

1. Diverticulitis: https://www.bjs.co.uk/article/randomized-clinical-trial-of-observational-versus-antibiotic-treatment-for-a-first-episode-of-ct-proven-uncomplicated-acute-diverticulitis/

2. Ankle Fracture: http://jamanetwork.com/journals/jama/fullarticle/2565749

Good Stuff

1. The Impact of Rudeness: https://coreem.net/journal-reviews/the-impact-of-rudeness/

2. Scrambling Names?: http://www.npr.org/sections/health-shots/2017/01/16/509353565/when-the-brain-scrambles-names-its-because-you-love-them?utm_medium=RSS&utm_campaign=health

Music Credits

The Rounds Table Theme Music by Brendan Quinn, Creative Director and Composer, Vapor RMW

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