Roadmap for the Management of Acute Undifferentiated Febrile Illness: An Expert Discussion and Review of Available Guidelines.

Acute undifferentiated febrile illnesses (AUFIs) are associated with specific characterizations like fever of less than two weeks' duration with no organ-specific symptoms at onset. These range from mild and self-limiting disease to progressive, life-threatening illness. Acute undifferentiated febrile illnesses are classified into malaria and non-malarial illnesses on the basis of microscopy or malariadiagnostic tests. Various challenges, such as comorbidities, geriatrics, pregnancy, and immune-compromised profile of the patient, impede the treatment regimen. Identifying the root cause of undifferentiated fever becomes critical and involves correct diagnostic tests along with empirical treatment initiation. Doxycycline, being a broad-spectrum antibiotic, confers activity against many Gram-positive, Gram-negative, and "atypical" bacteria. Apart from antimicrobial activity, Doxycycline demonstrates the potential to inhibit dengue virus replication and exhibits anti-inflammatory activity by down-regulating proinflammatory cytokine levels. As coronavirus disease 2019 (COVID-19) spreads, the clinical management of associated cytokine storm remains unanswered. Considering the probable beneficial effect of doxycycline, it has been recommended by the national and international experts for the empirical management of COVID-19.

Effectiveness of Nimesulide in Acute Fever Management in Adults: Retrospective Electronic Medical Records Database Study Outcome in Outpatient Department.

BACKGROUND: Various clinical trials have established anti-inflammatory and antipyretic properties of Nimesulide in a controlled setting, however, the fever management in real-world settings is quite different. OBJECTIVE: To assess the effectiveness of Nimesulide in acute fever management in real-world clinical practice. METHODOLOGY: A retrospective, multicenter study was conducted on electronic medical records (EMR) of 302 patients visiting out-patient departments at three centers between Jan 2016 and Jan 2020 and were prescribed Nimesulide for acute fever. The effectiveness of Nimesulide was analyzed as a change in fever from baseline to follow-up visit within 14 days and tolerability as the number of side effects captured post-Nimesulide ingestion. RESULTS: The provisional diagnosis at the baseline visit reported major complaints like fever, fever with abdominal pain, body-ache, cough and myalgia. The mean baseline body temperature was 103.2±1.5°F with a mean duration of 4.4±2.8 days significantly (p 0.0001) decreased to 99.7±1.8°F on the administration of Nimesulide. The liver and the renal profiles were found to be normal on records, and the side effects such as nausea and dyspepsia were reported only in 2% of patients. CONCLUSION: Nimesulide was found to be well-tolerated and effective as an antipyretic for acute fever management in adults during short-term use in real-world clinical practice.

Why family physicians?

Family medicine is the discipline on which family practice is based. It describes the body of knowledge, skills and attitudes that are necessary for family physicians to deal with problems brought to them by patients and relatives. Family physician should have the skill to assess the illness of his patients and should adopt a holistic approach in the management of his patients. The roles of the family physician describe the different types of care they provide eg, first contact care, personalised care and family care, continuity of care, comprehensive care, preventive care, co-ordination of care.