Volume 17, Number 2

Anne H Thomson MD FRCP FRCPCH Consultant in Paediatric Respiratory Medicine, John Radcliffe Hospital, Oxford

Respiratory tract infections – predominantly viral – are common in children. The preschool child, for example, averages between six and ten respiratory infections a year, mostly during the winter. Despite their likely viral aetiology, antibiotics are often prescribed for these illnesses.

Philip Ind, Editor

GPs and patients are frequently exhorted to avoid antibiotics. In this issue of the journal, Dr Anne Thomson reviews the use of antibiotics in respiratory tract infections in children (pages 5–7). She concludes that antibiotics are only needed in pneumonia which is severe, associated with a high fever or not improving after 48 hours.

Caroline Pao MRCP Clinical Research Fellow; Sheila McKenzie MD FRCP Consultant Paediatrician and Honorary Senior Lecturer, Queen Elizabeth Children’s Service, Royal London Hospital

Respiratory illnesses account for more than half of all illness in the preschool age group and account for one third of GP attendances in children under 11 years old. Part of the symptomatology is recurrent or persistent cough (PC).

Michael Rudolf MA MB FRCP Consultant Physician, Ealing Hospital, Chairman of the BTS COPD Consortium

The British Thoracic Society (BTS) guidelines for the management of chronic obstructive pulmonary disease (COPD) were published in December 19971 and reviewed in this journal early in 1998.2 Previous experience in producing asthma guidelines highlighted the importance of not simply publishing guidelines but also of having a strategy for the dissemination and implementation of their recommendations into clinical practice.

Tim Howes MBBS MA MRCPI MD Consultant Chest Physician, Thoracic Medicine; David Green BPharm MRPharm Community Liaison Pharmacist Colchester General Hospital

The use of home oxygen therapy in chronic obstructive pulmonary disease (COPD) has been discussed recently in this journal,1 and its benefits are well established. Although pertinent issues on the use of oxygen therapy in COPD have been incorporated into guidelines in the UK and other countries,2–4 many prescriptions for long-term oxygen therapy (LTOT) do not conform to these guidelines.5–7

Michael Davies MRCP Clinical Research Fellow, Duncan Geddes MD FRCP Professor of Respiratory Medicine, Royal Brompton Hospital, London

Lung reduction surgery is an emerging option in the treatment of severe pulmonary emphysema. This article describes the procedure, nominates those who may benefit from it (and the degree of benefit) and considers the questions that remain unanswered.

Noeleen M Foley MB BCh BAO MD MRCPI FRCP Consultant Physician in Respiratory and General Medicine, Royal United Hospital, Bath

Few acute conditions have such a wide spectrum of severity or variety of presentation as acute pulmonary embolism (PE). Its incidence is not known but is estimated at approximately 25 per 100,000 of the population per year in the UK, although many cases are diagnosed post-mortem in association with advanced malignancy, cardiac problems or respiratory disease.