Last month the Food and Drug administration (FDA) formally put out an alert linking the risk of proton pump inhibitors (PPI) to clostridium difficile associated diarrhea. Though this has been known for some time it was only now that the concerns have been raised to the level of a safety alert.
The PPIs are often viewed as a safe class of drug and are often started for valid reasons but not stopped even after the original indication is gone. As the incidence of recurrent and refractory clostridium difficile becomes an every growing problem especially in the elderly who are often on PPIs it is becoming necessary to evaluate the risks and benefits of continuing PPIs long term.
Bottom line: Stop PPIs if there is not longer a clear reason to be taking them.
Safety Alerts for Human Medical Products > Proton Pump Inhibitors (PPIs) – Drug Safety Communication: Clostridium Difficile-Associated Diarrhea (CDAD) Can be Associated With Stomach Acid Drugs.
Update on the 2010-11 annual influenza vaccination season related adverse effects.
Some of the notable highlights include no increase in febrile seizures in children, no increase in post vaccine fever in adults when compared to placebo (the main hesitation to give it in hospitalized patients).
Anaphylaxis or immediate hypersensitivity is estimated to be rare (1.5 case per million doses) No cases of anaphylaxis was reported in the 2010-11 season.
Botton line: adverse events related to trivalent influenza vaccine (TIV) are very rare for all age groups. It is a safe and cost effective means to reduce influenza related morbidity and mortality.
CDC – Seasonal Influenza Flu – Adverse Events After Receipt of TIV.
12 yr old otherwise healthy young man presents to his primary care physician office with a rash on the right calf for about a week.
Would you believe that parents (who do not believe in vaccination) are sending infected lollipops in the mail to one another to infect their children?
Swapping Chicken Pox-Infected Lollipops Illegal.
MRSA – why do we do what we do?
I recently presented a 30 minute lecture on MRSA control in the hospital setting at the fall symposium sponsored by Centegra Health System. The lecture describes the background of how MRSA is spread within medical facilities, the effects of its spread and measures that can be used to control it. The lecture also goes over some of the success stories of what an MRSA control program can expect to achieve. I also cover some of the historical background of how something as basic as hand washing became an actual event in medical history. I closed the lecture with some questions from the audience.
Immunization programs do work. This report from the CDC outlines remarkable progress against the terrible disease of polio which would affect over 50,000 cases per year just 20 years ago is now on the verge or eradication. Sabin and Jenner would be proud.
Progress Toward Poliomyelitis Eradication — India, January 2010–September 2011.
Eli Lilly the manufacturer of Xigris drotrecogin alfa (activated) voluntarily withdrew it from the market today after further study did not show survival benefit.
Xigris did not show survival benefit
Egg allergy and Influenza vaccination – is it a real issue?
It appears that this may not be an issue after all. Updated recommendations from the CDC now support vaccinating most patients with egg allergies. Continue reading
Improved childhood vaccination is reducing the death rate of children in Mexico.
Childhood Diarrhea Deaths after Rotavirus Vaccination in Mexico — NEJM.
Collecting a pertussis specimen
We had a bit of confusion of pertussis collection this weekend, so I put together a brief overview on pertussis with focus on nasopharyngeal specimen collection for pertussis.