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This week in medical news: stories that are relevant to many of us. May 18, 2016

Posted by drolarn in Uncategorized.
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I hope to blog on new medical articles that catch my eye 2-3 times a month, with my take on the subject. Questions and discussions welcomed!

 

FDA Calls for More Restrictions on Fluoroquinolone Use

Fluoroquinolone is a class of antibiotic that is very frequently used in this country, in adults and less so but my no means infrequently, in children. It is relatively new and bacterial resistance is not yet widespread but like ALL strong new antibiotics, frequent misuse is leading to it becoming less effective, and from what I have observed, it is misused many  more times than it is appropriately used. But that is not the only problem, this class of medicine has substantial toxicity. This is what the FDA says:

The risks for “disabling and potentially permanent” side effects associated with systemic fluoroquinolone antibacterials (e.g., ciprofloxacin, moxifloxacin) generally outweigh the benefits in patients with sinusitis, bronchitis, and uncomplicated urinary tract infections, the FDA warned late last week. Fluoroquinolones should only be used for these indications when patients don’t have other treatment options, the agency said.

– See more at:

http://www.jwatch.org/fw111568/2016/05/16/fda-calls-more-restrictions-fluoroquinolone-use?query=pfwTOC&jwd=000013394434&jspc=OBG#sthash.bdlOxj1L.dpuf

Should you listen to your doctor and be compliant when she prescribe Ciprobay® or Avelox® to you? Perhaps ask her how often she prescribes it. If she says very rarely, in your case you need it, then may be OK, but if she says oh I use it all the time it works great, then perhaps be a bit sceptical.

 

Peanuts for your baby?

The evidence for massive reduction of severe peanut allergy risk by early introduction of peanuts in infants less than 6 months of age continue to mount and has turned much of established food allergy avoidance practices on its head.  In the past many doctors gave food avoidance advice for babies based only on weak anecdotal evidence, and many still do.  Instructions on how and when to introduce new foods to babies can get as complicated as you like. The evidence for the benefit of early introduction of peanuts to high risk babies is overwhelming now. The question is: which if any high allergy risk food would also be better introduced earlier rather than avoided for years, like egg white, wheat products, dairy and sea food?

When is bellyaching real?

Non-specific abdominal pain NSAP, and Recurrent Abdominal Pain of Childhood are very common diagnoses. Chances are if  you child has a short lasting tummy ache that comes out of nowhere and just as mysteriously disappears, with no associated vomiting diarrhoea weight loss or loss of appetite, and recurring every now and then, then your child probably has non-specific recurrent abdominal pain of childhood, which is often not a very satisfying diagnosis as it gives no clue as to the cause, and consequently what can be done to prevent or treat the condition.

NSAP should be a common diagnosis as it is a common condition but doctors, and patients, mostly prefer more definitive diagnoses that justify specific treatments, and so other labels are often applied, most commonly dyspepsia or stomach ulcer type problems due to excess stomach acid. Dyspepsia can exist in children but it is extremely rare, it is mainly a condition of middle age men who smoke, drink and stress too much.

This paper shows that  cases of NSAP do not often turn out to be something more serious subsequently, which means judicious use of investigations and treatment should be the rule.

 

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