Chronic obstructive pulmonary disease (COPD) 

The 2010 NICE guidelines on COPD are currently under review as these were published before any LABA/LAMA or ICS/LABA/LAMA combination inhalers were available. 

Antimicrobial prescribing

NICE has continued to publish guidelines to support antimicrobial prescribing stewardship:

• Guidelines published for acute ear infections (otitis media) detail the strategy aiming to limit antibiotic use and reduce antimicrobial resistance
• NICE guidelines were also released with the aim of optimising antibiotic use for lower urinary tract infection in children, young people and adults who do not have a catheter
• Antimicrobial prescribing for acute sore throats’ aims to limit antibiotic use, as an acute sore throat is often triggered by a viral upper respiratory tract infection which lasts around a week
• A NICE medtech innovation briefing on point-of-care (PoC) diagnostic testing in primary care for Group A beta-haemolytic streptococcus (strep A) throat infection covered 11 technologies. Evidence from five tests suggests that PoC tests are more helpful for diagnosing strep A infection than clinical scoring systems alone in people with acute sore throat.

Alzheimer’s and dementia

Guidelines covering diagnosing and managing dementia (including Alzheimer’s disease) have been issued by NICE. Monotherapies of the acetylcholinesterase (AChE) inhibitors (donepezil, galantamine and rivastigmine) are recommended as options for managing mild to moderate Alzheimer’s disease.

Monotherapy of memantine is recommended as an option for managing people with moderate Alzheimer’s disease who are intolerant of or have a contraindication to AChE inhibitors, or have severe Alzheimer’s disease.

E-cigarettes

Public Health England (PHE) recommends that all services should offer support to smokers wishing to use an e-cigarette to stop smoking, however further randomised controlled trials are needed to assess the safety and effectiveness of e-cigarettes on smoking cessation or reduction.