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NICE Technology appraisal: Immunosuppressive therapy for kidney transplant in children and young people

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Evidence-based recommendations on immunosuppressive therapies for preventing kidney rejection in children and young people. The therapies are basiliximab (Simulect), immediate-release tacrolimus (Adoport, Capexion, Modigraf, Prograf, Tacni, Vivadex), mycophenolate mofetil (Cellcept and non-branded versions), rabbit anti-human thymocyte immunoglobulin (Thymoglobuline), prolonged-release tacrolimus (Advagraf, Envarsus), mycophenolate sodium (Myfortic, Ceptava), sirolimus (Rapamune), everolimus (Certican) and belatacept (Nulojix).

This guidance replaces NICE technology appraisal guidance 99.

Link to guidance here

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NICE Guideline: Child abuse and neglect

 

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This guideline covers recognising and responding to abuse and neglect in children and young people aged under 18. It covers physical, sexual and emotional abuse, and neglect. The guideline aims to help anyone whose work brings them into contact with children and young people to spot signs of abuse and neglect and to know how to respond. It also supports practitioners who carry out assessments and provide early help and interventions to children, young people, parents and carers.

Clinical features of abuse and neglect (including physical injury) are covered in NICE’s guideline on child maltreatment. Recommendations relevant to both health and social care practitioners appear in both guidelines.

Link to guideline here

NICE Technology Briefing: Thora-3Di for assessing asthma in children

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  • The technology described in this briefing is Thora‑3Di for assessing respiratory function in children with asthma.
  • The innovative aspects are that the measurements are taken non-invasively without the need for special breathing manoeuvres, and provide information on right-versus-left lung function.
  • The intended place in therapy would be instead of spirometry in secondary care in children for conditions such as asthma.
  • The main points from the evidence summarised in this briefing are from 5 prospective, observational studies including a total of 129 patients and 139 healthy controls (young people and children) in secondary care. They show that Thora‑3Di may be as effective as spirometry in assessing asthma respiratory parameters in children and young people.
  • Key uncertainties around the evidence or technology are that it is not clear which of the breathing parameters measured by Thora‑3Di are specific to assessing asthma, and that there is limited evidence comparing these measures with spirometry.
  • The cost of Thora‑3Di is £25,000 per unit (exclusive of VAT). The resource impact is unclear, but using the device could save costs through quicker testing.

Test children’s urine before prescribing antibiotics for UTIs, says NICE

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NICE has updated its guidance for diagnosing and managing UTIs in children.

The new recommendations give clear advice to GPs and healthcare professionals about how they can accurately test children’s urine for an infection.

This will help to give them a better indication of whether the child needs antibiotics or not. Therefore assisting in the fight against antibiotic resistance, which can be caused by the misuse of medicine.

A dipstick test offers a quick and painless way to check a child’s urine for signs that their body is fighting an infection.

NICE says children between the age of three months and three years should not be given antibiotics if their dipstick test is negative.

Children over the age of three years may need to be given antibiotics if their urine dipstick analysis shows mixed results and they have other obvious symptoms of a UTI (for example painful urination).

Children under three months of age who are suspected of having a UTI should not have a dipstick test. They should be referred to paediatric specialist care and their urine sent for urgent laboratory analysis.

NICE Quality Standard: End of life care for infants, children and young people

This quality standard covers end of life care for infants, children and young people (from birth to 18 years) who have a life-limiting condition. Life-limiting conditions are those that are expected to result in an early death for the person. It also covers support for family members and carers. It describes high-quality care in priority areas for improvement.

Link to guidance here