No abstract

BackgroundThe extra-intestinal manifestation of tracheobronchitis is a rare complication of ulcerative colitis (UC). Here, we present a case of UC-related tracheobronchitis wherein the positive clinical effects of infliximab are demonstrated.Case presentationWe report the case of a 39-year old woman who presented with a chronic productive cough on a distant background of surgically managed ulcerative colitis (UC). Our patient failed to achieve a satisfactory clinical improvement despite treatment with high dose inhaled corticosteroids, oral corticosteroids and azathioprine. Infliximab therapy was commenced and was demonstrated to achieve macroscopic and symptomatic remission of disease.ConclusionsWe present the first case report documenting the benefits of infliximab in UC-related tracheobronchitis.

Summary Pregnancy is known to be a time of increased susceptibility to acquiring to human immunodeficiency virus (HIV) infection and this increased maternal risk places the unborn child at risk of vertical transmission. Pre‐exposure prophylaxis (PrEP) involves the provision of antiretroviral therapy to an HIV‐negative individual with ongoing risk of HIV exposure to limit the likelihood of HIV transmission. The inclusion of PrEP as part of a comprehensive strategy is recognised as an effective and safe means of reducing HIV infection in serodiscordant couples, thereby reducing the risk of vertical transmission of HIV. Current data suggest that PrEP is safe to continue during pregnancy and breastfeeding in HIV‐negative women who remain vulnerable to acquiring HIV. The recent Pharmaceutical Benefits Scheme subsidisation of PrEP has reduced the financial and practical obstacles of PrEP provision, and a subsequent increase in patient awareness and acceptance of PrEP is expected. The framework for appropriately identifying and managing at‐risk pregnant and lactating women requiring PrEP is poorly defined and warrants further clarification to better support clinicians and this patient group. This review discusses the current recommendations highlighting the gaps in the guidelines and makes some recommendations for future guideline development.

A subcommittee of the Drug and Therapeutics committee has been established to review drug allergies and adverse drug reactions (ADRs) encountered in the hospital. The multidisciplinary team consists of a consultant immunologist, general medical practitioner, allergy team pharmacist(s), director of pharmacy (organisational Governance representative), allergy nurse, and external expert (senior university staff ).The ADR review group was established 5 years ago and meets bimonthly. Staffs are encouraged to report hospital encountered allergies/ADRs to the group who takes varied and appropriate actions and interventions. Various tools have been developed via this group to better manage drug allergies, and projects and publications have ensued.A form has been developed and widely made available to the organisation, to be completed by any healthcare professional, who encounters a patient with ADR/drug allergy. The completed forms are submitted to the allergy pharmacist who collates them and presents them to the group at the bimonthly ADR group meetings. Each reported ADR is discussed in detail and appropriate action implemented. This includes updating patient hospital records, reporting to the national Pharmacovigilance database and providing feedback to General Practitioners, patients and carers.This group also monitors new research, trends in ADR reports, provide feedback to clinical teams, and undertakes research and service improvement projects. The group also undertakes and organises education of the hospital staff regarding allergies and ADR management.The ADR review group works as an advocate for improved patient safety and the prevention of drug errors. The group works closely with ASCIA representatives to share learnings and initiatives. We feel other institutions would benefit from a similar structure. TEN is an extremely rare complication of drug treatment (estimated at 1-2 cases per million each year). 1 Chronic non-granulomatous supraglottitis is an unusual disease rarely reported in paediatric medical literature. P18 A RARE CASE OF CHRONIC NON GRANULOMATOUS SUPRAGLOTTITIS AND TOXIC EPIDERMAL NECROLYSIS (TEN) SECONDARY TO ITS TREATMENT IN A TEENAGE GIRL 2Case history: A 13-year-old girl presented to our regional hospital on 6 February 2017 with gradually worsening history of dysphonia, lethargy, and weight loss (7.3%) since October 2016. She had two courses of oral Augmentin-duo for ongoing symptoms of fever, dyspnoea and cough by November 2016. A chest X-ray was suggestive of left sided consolidation at the time. Paired sera 4 weeks apart in January and February showed positive IgA, IgG and negative IgM antibody titres to Chlamydiae Pneumoniae and she was given a 5-week course of doxycycline for a presumptive diagnosis of atypical pneumonia. Cough, dyspnoea and chest X-ray abnormalities resolved by January 2011. Her only significant past medical history was eczema.Systemic examination was normal except mild inspiratory stridor. Direct flexible laryngoscopy (DFL) revealed appearance of supraglottitis. She...

No abstract