Issue 41 December 2011
Contents
Vulvovaginal health in premenopausal women
Symptoms relating to the vulvovaginal area such as abnormal discharge, itch and pain are common, particularly for women of reproductive age. As well as accounting for numerous general practice consultations, self-diagnosis and self-treatment with over-the-counter products are frequent. This article covers the identification and management of bacterial vaginosis, vulvovaginal candidiasis, retained foreign bodies, vulval itch (including lichen sclerosus and lichen planus), vulval pain and “lumps and bumps” (including complications from hair removal, Bartholin gland cysts and vulval skin lesions).
Appropriate use of cephalosporins
There are very few indications for the use of cephalosporins as first-line antibiotic treatment. Ceftriaxone is used for the treatment of gonorrhoea, pelvic inflammatory disease and epididymo-orchitis. It is also an alternative to benzylpenicillin in patients with suspected meningitis. Cefaclor may be considered as a second-line treatment for infections such as otitis media, sinusitis, cellulitis, diabetic foot infection and mastitis. Cephalexin is a third-line treatment for urinary tract infection in pregnant women.
Providing medical advice to travellers
New Zealanders love to travel. It is important that travellers visit their general practice (or travel medicine clinic) at least six to eight weeks prior to departure to an international location. A travel medicine assessment typically includes advice about avoidance of risks, prescription of prophylactic medicines such as antimalarials and administration of indicated vaccinations.
PHO Performance Programme – six years on
The PHO Performance Programme was established in 2005 to improve the health of people enrolled in general practices in New Zealand and to reduce inequalities in health outcomes for high need populations. The results and successes of the Programme over the past six years are presented. Overall, progress has been made in all indicators, although there have been significant challenges in achieving some Programme goals.
