Clarity’s Diagnosis and Treatment Guidance July 2022 Update

This update contains 6 significant changes and 8 minor changes.

Significant Changes

• Conjunctivitis – allergic — reviewed. A literature search was conducted in April 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of this topic. No major changes to the recommendations have been made.
• Candida – skin — reviewed. A literature search was conducted in May 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials (RCTs) published since the last revision of the topic. No major changes to recommendations have been made.
• Headache – medication overuse — reviewed. A literature search was conducted in April 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. The recommendations have been updated in line with current evidence in the literature. No major changes to the recommendations have been made.
• Compression stockings — reviewed. A literature search was conducted in April 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. Updated literature has been incorporated to provide supporting evidence for the guidance. No major changes to the clinical recommendations have been made.
• Scabies — reviewed. A literature search was conducted in April 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of this topic. No major changes to the recommendations have been made.
• Generalized anxiety disorder — reviewed. A literature search was conducted in May 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of this topic. Some minor structural changes have been made to this topic, but there have been no major changes to the recommendations.

Minor Changes

• Gastroenteritis — minor update. Minor typographical error corrected and the information on clarithromycin interactions in the prescribing information section has been consolidated and updated.
• Corticosteroids – topical (skin), nose, and eyes — minor update. Additional information about the possibility of topical steroid withdrawal syndrome has been added to the Basis for recommendation section on withdrawal of topical corticosteroids in line with the updated Summary of Product Characteristics of some topical corticosteroid products.
• Depression — minor update. Telephone number for Samaritans has been updated.
• Anticoagulation – oral — minor update. A typographical error has been corrected.
• Chickenpox — minor update. A typographical error has been corrected.
• Diabetes – type 2— minor update. Adverse effect of increased risk of vitamin B12 deficiency associated with metformin added, based on a drug safety update from MHRA.  Revised dosing of metformin modified release in renal impairment to align with standard metformin.
• Shingles — minor update. Added adverse effect relating to Shingrix from the manufacturer’s SPC of a small risk of Guillain-Barre.
• Urinary tract infection (lower) – men — minor update. The 2012 SIGN Guideline Management of suspected bacterial infection in adults has been replaced with a guideline which solely applies to women.