Abstract
Nullius in verba-Whom/What should we believe in GU Medicine?
Highlights
In September 2013, I was invited to talk at the first 'Preventing Overdiagnosis' conference, held at Dartmouth College in New Hampshire, USA
Conflicts of interest (COI) were notable by their absence. This lecture formed the basis of my presentation at the SLCV 19'11 Academic Sessions entitled ' Overdiagnosis in Sexually transmitted Infections ' but the content of the talk ended up dealing more widely with conflict of interest (COi), a subject that I have returned to over the years in Colombo[2]
Kidney disease' ; it comes as no surprise to learn that nine of 16 members of the guidelines working party had ties with industry and that ''.funding came from a consortium of pharmaceutical or device manufacturers"[4]
Summary
In September 2013, I was invited to talk at the first 'Preventing Overdiagnosis' conference, held at Dartmouth College in New Hampshire, USA. The recommendations io, 11 12 and prescription of antigonococcal therapy in PID are confounded by a combination of factors: a 'shortage' of gonorrhoea, confused definition and poor diagnosis. These matter since serious antimicrobial resistance threatens total loss of therapeutic options. American 12 guidelines all recommend the use of anti-gonococcal antibiotics (cephalosporins, usually ceftriaxone) in ' undiagnosed' PID, in spite of acknowledging the importance of non-infectious causes They all suggest empirical treatment for partners, in one case 12 "regardless of the etiology of PID or pathogens isolated.from the infected woman" (my italics). There have been several reports ofceftriaxone treatment failures 16 and the WHO has produced a global action plan to control the speed and impact of antimicrobial resistance in N.gonorrhoeae17 We cannot afford to squander our last remaining weapon!
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