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Your efforts to find the answer in evidence were met by the patient's
experience, expectations and fears. This is perhaps why EBM has not made
the changes to practice at the speed that some would suggest.
Could I suggest that the delivery of intravenous antibiotics in a
stable patient with a clear diagnosis who requires such treatment (such as
the one you describe) could have been managed using a skilled Hospital in
the Home Unit. The patient's anxiety about appropriate therapy would have
been managed, and the outcome would have been positive. The benefits you
cite for oral therapy (e.g. reducing risk of nosocomial infection) would
be combined with the effectiveness of, and desire for, intravenous
therapy.
The title of "Evidence-based case report Antibiotic treatment for
spontaneous bacterial peritonitis" is absorbing.It indicated that the
evidence-based medicine turned into practice. How to assess the evidence is
the key step .But this article didn't offer the method of assessing
evidence:the quality of the literature, the standard of assessing,the
levels of evidence,the forms of the evidence etc .
Competing interests:
No competing interests
15 January 2002
LIU Xue mei
director of the department of Chinese Journal of Evidence-Based Medicine
610041 West China Hospital, Sichuan University,China
Right answer, wrong question?
Your efforts to find the answer in evidence were met by the patient's
experience, expectations and fears. This is perhaps why EBM has not made
the changes to practice at the speed that some would suggest.
Could I suggest that the delivery of intravenous antibiotics in a
stable patient with a clear diagnosis who requires such treatment (such as
the one you describe) could have been managed using a skilled Hospital in
the Home Unit. The patient's anxiety about appropriate therapy would have
been managed, and the outcome would have been positive. The benefits you
cite for oral therapy (e.g. reducing risk of nosocomial infection) would
be combined with the effectiveness of, and desire for, intravenous
therapy.
Competing interests: No competing interests