Matching articles for "Bactrim"
Omadacycline (Nuzyra) - A New Tetracycline Antibiotic
The Medical Letter on Drugs and Therapeutics • May 20, 2019; (Issue 1572)
The FDA has approved omadacycline (Nuzyra – Paratek),
a semisynthetic tetracycline derivative, for once-daily
IV and oral treatment of community-acquired bacterial
pneumonia (CAP) and acute bacterial skin...
The FDA has approved omadacycline (Nuzyra – Paratek),
a semisynthetic tetracycline derivative, for once-daily
IV and oral treatment of community-acquired bacterial
pneumonia (CAP) and acute bacterial skin and skin
structure infections (ABSSSIs) in adults.
Sulfonamide Cross-Reactivity
The Medical Letter on Drugs and Therapeutics • March 25, 2019; (Issue 1568)
A reader has questioned why the label for the COX-2
selective NSAID celecoxib (Celebrex, and generics),
which contains a sulfonamide moiety, states that it
is contraindicated for use in patients with an...
A reader has questioned why the label for the COX-2
selective NSAID celecoxib (Celebrex, and generics),
which contains a sulfonamide moiety, states that it
is contraindicated for use in patients with an allergy
to sulfonamides, while the labels of some other
sulfonamide drugs recommend either caution or no
precautions at all. The concept of cross-reactivity
among sulfonamide drugs, particularly between
antibacterial and nonantibacterial sulfonamides, has
been controversial for many years.
Comparison Table: Some Antibiotics for MRSA Skin and Skin Structure Infections (online only)
The Medical Letter on Drugs and Therapeutics • March 26, 2018; (Issue 1543)
...
View the Comparison Table: Some Antibiotics for MRSA Skin and Skin Structure Infections
Drugs for Common Bacterial Infections in Adults
The Medical Letter on Drugs and Therapeutics • October 23, 2017; (Issue 1532)
Bacterial infections in adults are generally treated
empirically, with the antibiotic covering most, but not
all, of the potential causative pathogens. For some
infections, culture and sensitivity testing...
Bacterial infections in adults are generally treated
empirically, with the antibiotic covering most, but not
all, of the potential causative pathogens. For some
infections, culture and sensitivity testing can guide
treatment, allowing for use of narrower-spectrum
antibiotics. The recommended dosages and durations
of antibiotic treatment for common respiratory, skin, and
urinary tract infections are listed in Tables 1-3. Infectious
disease experts now recommend shorter treatment
durations for many infections to reduce the development
of antimicrobial resistance and minimize adverse effects.
Alternatives to Fluoroquinolones
The Medical Letter on Drugs and Therapeutics • June 6, 2016; (Issue 1496)
The FDA has announced that it is requiring changes in
the labeling of systemic fluoroquinolones to warn that
the risk of serious adverse effects, including tendinitis,
peripheral neuropathy and CNS effects,...
The FDA has announced that it is requiring changes in
the labeling of systemic fluoroquinolones to warn that
the risk of serious adverse effects, including tendinitis,
peripheral neuropathy and CNS effects, generally outweighs
their benefit for the treatment of acute sinusitis,
acute exacerbations of chronic bronchitis, and uncomplicated
urinary tract infections. For these infections, the
new labels will recommend reserving fluoroquinolones
for patients with no other treatment options.
Drugs for Inflammatory Bowel Disease
The Medical Letter on Drugs and Therapeutics • August 4, 2014; (Issue 1448)
Aminosalicylates are effective for induction and maintenance
of remission in mild to moderate ulcerative
colitis. They are not recommended for treatment of
Crohn's disease.
FORMULATIONS — Oral mesalamine...
Aminosalicylates are effective for induction and maintenance
of remission in mild to moderate ulcerative
colitis. They are not recommended for treatment of
Crohn's disease.
FORMULATIONS — Oral mesalamine is rapidly absorbed in the small intestine and most of the drug does not reach the colon. Pentasa releases mesalamine gradually throughout the gastrointestinal tract. Delzicol, Asacol HD, Lialda, and Apriso delay the release of the drug until it reaches the distal ileum and colon. Sulfasalazine (Azulfidine, and generics), balsalazide (Colazal, and others), and olsalazine (Dipentum) are prodrugs; mesalamine is azo-bonded to a second moiety and released in the colon following bacterial cleavage of the bond. Mesalamine is also available as an enema (Rowasa, and generics) and as a rectal suppository (Canasa).
FORMULATIONS — Oral mesalamine is rapidly absorbed in the small intestine and most of the drug does not reach the colon. Pentasa releases mesalamine gradually throughout the gastrointestinal tract. Delzicol, Asacol HD, Lialda, and Apriso delay the release of the drug until it reaches the distal ileum and colon. Sulfasalazine (Azulfidine, and generics), balsalazide (Colazal, and others), and olsalazine (Dipentum) are prodrugs; mesalamine is azo-bonded to a second moiety and released in the colon following bacterial cleavage of the bond. Mesalamine is also available as an enema (Rowasa, and generics) and as a rectal suppository (Canasa).
Treatment of Atrial Fibrillation
The Medical Letter on Drugs and Therapeutics • July 7, 2014; (Issue 1446)
The treatment of atrial fibrillation includes anticoagulation,
rate control, and rhythm control. New US
guidelines for the management of atrial fibrillation
have recently been...
The treatment of atrial fibrillation includes anticoagulation,
rate control, and rhythm control. New US
guidelines for the management of atrial fibrillation
have recently been published.
Drugs for MRSA Skin and Soft-Tissue Infections
The Medical Letter on Drugs and Therapeutics • May 12, 2014; (Issue 1442)
Methicillin-resistant Staphylococcus aureus (MRSA),
which was traditionally a nosocomially-acquired
organism but now frequently occurs in the absence
of healthcare exposure, is the predominant cause...
Methicillin-resistant Staphylococcus aureus (MRSA),
which was traditionally a nosocomially-acquired
organism but now frequently occurs in the absence
of healthcare exposure, is the predominant cause of
suppurative skin and soft-tissue infections in many parts
of the US. Community-associated MRSA usually
causes furunculosis, purulent cellulitis, and abscesses,
but necrotizing fasciitis, necrotizing pneumonia, and
sepsis can also occur.
Drugs for Bacterial Infections
The Medical Letter on Drugs and Therapeutics • July 1, 2013; (Issue 131)
The text that follows reviews some common bacterial
infections and their empiric treatment pending the
results of culture and susceptibility testing. The recommendations
made here are based on the results...
The text that follows reviews some common bacterial
infections and their empiric treatment pending the
results of culture and susceptibility testing. The recommendations
made here are based on the results of
susceptibility studies, clinical trials, and the opinions
of Medical Letter reviewers. Tables 1 and 2 list the usual
dosages of antibacterial drugs.
Drugs for Acne, Rosacea and Psoriasis
The Medical Letter on Drugs and Therapeutics • January 1, 2013; (Issue 125)
The pathogenesis of acne is multifactorial: follicular
hyperkeratinization, bacteria, sebum production,
androgens, and inflammation all play a role. The gram-positive
microaerophilic bacteria...
The pathogenesis of acne is multifactorial: follicular
hyperkeratinization, bacteria, sebum production,
androgens, and inflammation all play a role. The gram-positive
microaerophilic bacteria Propionibacterium
acnes promote development of acne lesions by secreting
chemotactic factors that attract leukocytes to the
follicle, causing inflammation.
Addendum: Cost of Drugs for Acute Cystitis
The Medical Letter on Drugs and Therapeutics • August 20, 2012; (Issue 1397)
A reader suggested that our July 23 article on Drugs for Urinary Tract Infection (Med Lett Drugs Ther 2012; 54:57)1 should have included information on the cost of the drugs we recommended for treatment of...
A reader suggested that our July 23 article on Drugs for Urinary Tract Infection (Med Lett Drugs Ther 2012; 54:57)1 should have included information on the cost of the drugs we recommended for treatment of acute uncomplicated cystitis.
Trimethoprim/sulfamethoxazole DS — Generic formulations are available at large discount pharmacies for $4 for 20 tablets. Trimethoprim/sulfamethoxazole DS is generally found on tier 1 (lowest co-pay) of insurance company formularies.
Nitrofurantoin monohydrate/macrocrystals — The wholesale acquisition cost of the generic formulation is about $2.50 per tablet (PricePointRx™).2 The drug is on tier 1 of some insurance company formularies, but on tier 2 or 3 of others.
Fosfomycin — Available only as Monurol, a single dose of fosfomycin is effective in most cases of acute uncomplicated cystitis, but the manufacturer charges a wholesale acquisition cost of more than $40 for that dose (PricePointRx™).2 Most insurance companies place Monurol on tier 3 of their formularies, or do not include it on their formularies at all.
Not recommended: Ciprofloxacin – Fluoroquinolones should not be used empirically to treat acute uncomplicated cystitis. The fact that ciprofloxacin is available at large discount pharmacies for $4 for 20 500-mg tablets and is on tier 1 on most insurance company formularies may be part of the reason for its continued overuse.
1. Drugs for urinary tract infection. Med Lett Drugs Ther 2012; 54:57.
Trimethoprim/sulfamethoxazole DS — Generic formulations are available at large discount pharmacies for $4 for 20 tablets. Trimethoprim/sulfamethoxazole DS is generally found on tier 1 (lowest co-pay) of insurance company formularies.
Nitrofurantoin monohydrate/macrocrystals — The wholesale acquisition cost of the generic formulation is about $2.50 per tablet (PricePointRx™).2 The drug is on tier 1 of some insurance company formularies, but on tier 2 or 3 of others.
Fosfomycin — Available only as Monurol, a single dose of fosfomycin is effective in most cases of acute uncomplicated cystitis, but the manufacturer charges a wholesale acquisition cost of more than $40 for that dose (PricePointRx™).2 Most insurance companies place Monurol on tier 3 of their formularies, or do not include it on their formularies at all.
Not recommended: Ciprofloxacin – Fluoroquinolones should not be used empirically to treat acute uncomplicated cystitis. The fact that ciprofloxacin is available at large discount pharmacies for $4 for 20 500-mg tablets and is on tier 1 on most insurance company formularies may be part of the reason for its continued overuse.
1. Drugs for urinary tract infection. Med Lett Drugs Ther 2012; 54:57.
2. PricePointRx™. Reprinted with permission by FDB. All rights reserved. ©2012. http://www.firstdatabank.com/support/drug-pricing-policy.aspx. Accessed July 31, 2012. Actual retail prices may be higher.
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Drugs for Urinary Tract Infections
The Medical Letter on Drugs and Therapeutics • July 23, 2012; (Issue 1395)
The most recent guidelines from the Infectious
Diseases Society of America (IDSA) and its European
counterpart on the choice of antimicrobials for treatment
of uncomplicated urinary tract infections (UTIs)...
The most recent guidelines from the Infectious
Diseases Society of America (IDSA) and its European
counterpart on the choice of antimicrobials for treatment
of uncomplicated urinary tract infections (UTIs) in
non-pregnant women focus on the unnecessary use of
fluoroquinolones to treat uropathogens that are
increasingly becoming resistant to them. Resistance
of Escherichia coli to ciprofloxacin in the US has
increased from 3% in 2000 to 17.1% in 2010.
Drugs for Bacterial Infections
The Medical Letter on Drugs and Therapeutics • June 1, 2010; (Issue 94)
The text below reviews some common bacterial infections and their treatment. The recommendations made
here are based on the results of susceptibility studies, clinical trials and the opinions of Medical Letter...
The text below reviews some common bacterial infections and their treatment. The recommendations made
here are based on the results of susceptibility studies, clinical trials and the opinions of Medical Letter consultants.
Drugs for Inflammatory Bowel Disease
The Medical Letter on Drugs and Therapeutics • September 1, 2009; (Issue 85)
Inflammatory bowel disease (IBD) is either Crohn's disease or ulcerative colitis. Drug selection is guided by disease type (Crohn's versus ulcerative colitis), severity and location and whether the goal is...
Inflammatory bowel disease (IBD) is either Crohn's disease or ulcerative colitis. Drug selection is guided by disease type (Crohn's versus ulcerative colitis), severity and location and whether the goal is induction or maintenance of remission. Table 1 on page 66 lists the drugs used to treat IBD with their formulations and cost. Table 2 on page 68 lists the drugs of choice and their doses for different indications. Table 3 on page 71 lists the drugs' adverse effects and recommendations for monitoring. More detailed guidelines are available from the American College of Gastroenterology.
Drugs for MRSA with Reduced Susceptibility to Vancomycin
The Medical Letter on Drugs and Therapeutics • May 4, 2009; (Issue 1311)
The recent Medical Letter article on vancomycin dosing and monitoring briefly mentioned use of an alternative antibiotic for treatment of methicillin-resistant Staphylococcus aureus (MRSA) with reduced...
The recent Medical Letter article on vancomycin dosing and monitoring briefly mentioned use of an alternative antibiotic for treatment of methicillin-resistant Staphylococcus aureus (MRSA) with reduced susceptibility to vancomycin. Some readers have asked for more information on this subject.
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Drugs for Rheumatoid Arthritis
The Medical Letter on Drugs and Therapeutics • May 1, 2009; (Issue 81)
Disease-modifying anti-rheumatic drugs (DMARDs) are now used early in the treatment of rheumatoid arthritis (RA) to prevent irreversible damage to joints and minimize toxicities associated with nonsteroidal...
Disease-modifying anti-rheumatic drugs (DMARDs) are now used early in the treatment of rheumatoid arthritis (RA) to prevent irreversible damage to joints and minimize toxicities associated with nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids.
Drugs That May Cause Psychiatric Symptoms
The Medical Letter on Drugs and Therapeutics • December 15, 2008; (Issue 1301)
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment could also be due to the underlying illness, previously...
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment could also be due to the underlying illness, previously unrecognized psychopathology, or psychosocial factors. The withdrawal of some drugs can cause symptoms such as anxiety, psychosis, delirium, agitation or depression.
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Addendum: Warfarin-Acetaminophen Interaction
The Medical Letter on Drugs and Therapeutics • June 16, 2008; (Issue 1288)
A reader expressed disappointment that our recent listing of “Some Warfarin Drug Interactions”1 did not include acetaminophen. Perhaps it should have. Acetaminophen can increase the anticoagulant effect of...
A reader expressed disappointment that our recent listing of “Some Warfarin Drug Interactions”1 did not include acetaminophen. Perhaps it should have. Acetaminophen can increase the anticoagulant effect of warfarin, particularly with continued use, but it does so inconsistently. The mechanism of this interaction has not been established, but may be related to an acetaminophen metabolite inhibiting vitamin K-epoxide reductase, the target for warfarin’s anticoagulant effect.2
Patient susceptibility varies, possibly on a genetic basis; occasional use of acetaminophen generally has little or no effect on the international normalized ratio (INR) in patients on chronic warfarin therapy, but in some, even a few grams of the drug may cause a dramatic increase in INR. One study in healthy subjects found no effect of acetaminophen 4 g per day for 2 weeks, while another study in patients with the same acetaminophen dose for the same period of time found a moderate increase in INR.3,4 It might be prudent to monitor INR in patients on chronic warfarin therapy more closely than usual when they take more than 2 g per day of acetaminophen for more than a few days.
1. Pharmacogenetic-based dosing of warfarin. Med Lett Drugs Ther 2008; 50:39.
2. HH Thijssen et al. Paracetamol (acetaminophen) warfarin interaction: NAPQI, the toxic metabolite of paracetamol, is an inhibitor of enzymes in the vitamin K cycle. Thromb Haemost 2004; 92:797.
3. D Kwan et al. The effects of acetaminophen on pharmacokinetics and pharmacodynamics of warfarin. J Clin Pharmacol 1999; 39:68.
4. I Mahe et al. Paracetamol: A haemorrhagic risk factor in patients on warfarin. Br J Clin Pharmacol 2005; 59:371.
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Patient susceptibility varies, possibly on a genetic basis; occasional use of acetaminophen generally has little or no effect on the international normalized ratio (INR) in patients on chronic warfarin therapy, but in some, even a few grams of the drug may cause a dramatic increase in INR. One study in healthy subjects found no effect of acetaminophen 4 g per day for 2 weeks, while another study in patients with the same acetaminophen dose for the same period of time found a moderate increase in INR.3,4 It might be prudent to monitor INR in patients on chronic warfarin therapy more closely than usual when they take more than 2 g per day of acetaminophen for more than a few days.
1. Pharmacogenetic-based dosing of warfarin. Med Lett Drugs Ther 2008; 50:39.
2. HH Thijssen et al. Paracetamol (acetaminophen) warfarin interaction: NAPQI, the toxic metabolite of paracetamol, is an inhibitor of enzymes in the vitamin K cycle. Thromb Haemost 2004; 92:797.
3. D Kwan et al. The effects of acetaminophen on pharmacokinetics and pharmacodynamics of warfarin. J Clin Pharmacol 1999; 39:68.
4. I Mahe et al. Paracetamol: A haemorrhagic risk factor in patients on warfarin. Br J Clin Pharmacol 2005; 59:371.
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Pharmacogenetic-Based Dosing of Warfarin
The Medical Letter on Drugs and Therapeutics • May 19, 2008; (Issue 1286)
Warfarin sodium (Coumadin, and others) and other coumarin anticoagulants prevent thrombosis, but patient response is highly variable and overanticoagulation can lead to hemorrhage. Genotyping patients for...
Warfarin sodium (Coumadin, and others) and other coumarin anticoagulants prevent thrombosis, but patient response is highly variable and overanticoagulation can lead to hemorrhage. Genotyping patients for single nucleotide polymorphisms (SNPs) that affect coumarin metabolism and sensitivity may help clinicians estimate the therapeutic warfarin dose. The FDA has added a note to warfarin labeling recommending lowrange doses for patients with such genetic variations. Commercial tests for these variants are now available and cost about $500 per test.
Choice of Antibacterial Drugs
The Medical Letter on Drugs and Therapeutics • May 1, 2007; (Issue 57)
Information about empirical treatment of bacterial infections, emerging trends in antimicrobial resistance, new drugs and new data about older drugs continue to become available. Usual pathogens and empiric...
Information about empirical treatment of bacterial infections, emerging trends in antimicrobial resistance, new drugs and new data about older drugs continue to become available. Usual pathogens and empiric treatment for some common types of infections are summarized in the text and a table listing the drugs of choice and alternatives for each pathogen begins on page 40. The recommendations made here are based on the results of susceptibility studies, clinical trials and the opinions of Medical Letter consultants.
Treatment of Community-Associated MRSA Infections
The Medical Letter on Drugs and Therapeutics • February 13, 2006; (Issue 1228)
Methicillin-resistant Staphylococcus aureus (MRSA) infections, which have been a concern for many years, previously occurred primarily in hospitalized patients and those recently treated with antibiotics. In...
Methicillin-resistant Staphylococcus aureus (MRSA) infections, which have been a concern for many years, previously occurred primarily in hospitalized patients and those recently treated with antibiotics. In the past few years, there has been an increasing incidence worldwide of community-associated (CA) MRSA infections in patients without recent antibiotic exposure or contact with the healthcare system.
Drugs for Rheumatoid Arthritis
The Medical Letter on Drugs and Therapeutics • December 1, 2005; (Issue 40)
To prevent irreversible damage to joints and minimize toxicities associated with nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, disease modifying anti-rheumatic drugs (DMARDs) are now used...
To prevent irreversible damage to joints and minimize toxicities associated with nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, disease modifying anti-rheumatic drugs (DMARDs) are now used early in the treatment of rheumatoid arthritis (RA). The DMARDs listed in the table on page 84 have no immediate analgesic effects, but can control symptoms and have been shown to delay and possibly stop progression of the disease. The NSAIDs listed in the table on page 88 have analgesic and anti-inflammatory effects, but may not affect the disease process. Oral corticosteroids can rapidly relieve joint symptoms and control systemic manifestations, but their chronic use is associated with many complications.
Drugs for Head Lice
The Medical Letter on Drugs and Therapeutics • August 15, 2005; (Issue 1215)
Head lice occur in all age groups, but especially in elementary school children during the winter months. Infestations are becoming more difficult to treat because of increasing resistance to the chemical...
Head lice occur in all age groups, but especially in elementary school children during the winter months. Infestations are becoming more difficult to treat because of increasing resistance to the chemical pediculicides commonly used, particularly those that are available over-the-counter (OTC).
Drugs for Parasitic Infections
The Medical Letter on Drugs and Therapeutics • August 16, 2004; (Issue 1189)
Parasitic infections are found throughout the world. With increasing travel, immigration, use of immunosuppressive drugs and the spread of AIDS, physicians anywhere may see infections caused by previously...
Parasitic infections are found throughout the world. With increasing travel, immigration, use of immunosuppressive drugs and the spread of AIDS, physicians anywhere may see infections caused by previously unfamiliar parasites. The table below lists first-choice and alternative drugs for most parasitic infections. The brand names and manufacturers of the drugs are listed in this article.
Choice of Antibacterial Drugs
The Medical Letter on Drugs and Therapeutics • March 1, 2004; (Issue 19)
New drugs for bacterial infections and new information about older drugs continue to become available. Empirical treatment of some common bacterial infections is discussed in this article. A table listing the...
New drugs for bacterial infections and new information about older drugs continue to become available. Empirical treatment of some common bacterial infections is discussed in this article. A table listing the drugs of choice and alternatives for each pathogen begins on page 18. These recommendations are based on results of susceptibility studies, clinical trials and the opinions of Medical Letter consultants. Local resistance patterns should be taken into account. Trade names are listed on page 24.
Drugs for Rheumatoid Arthritis
The Medical Letter on Drugs and Therapeutics • January 1, 2003; (Issue 5)
Many different drugs are now used to treat rheumatoid arthritis. Nonsteroidal anti-inflammatory drugs (NSAIDs), listed in the table on page 26, have analgesic and anti-inflammatory effects, but may not affect...
Many different drugs are now used to treat rheumatoid arthritis. Nonsteroidal anti-inflammatory drugs (NSAIDs), listed in the table on page 26, have analgesic and anti-inflammatory effects, but may not affect the disease process. Corticosteroids can provide rapid relief of joint symptoms and control of systemic manifestations, but chronic use is associated with many complications. The "disease-modifying" anti-rheumatic drugs (DMARDs), listed on page 29, have no immediate analgesic effects, but can control symptoms and may delay progression of the disease (American College of Rheumatology Subcommittee on Rheumatoid Arthritis Guidelines, Arthritis Rheum 2002; 46:328). Interactions of anti-rheumatic drugs with other drugs are listed in The Medical Letter Handbook of Adverse Drug Interactions, 2003.
Drugs That May Cause Psychiatric Symptoms
The Medical Letter on Drugs and Therapeutics • July 8, 2002; (Issue 1134)
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment may also be due to the underlying illness, previously...
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment may also be due to the underlying illness, previously unrecognized psychopathology, or psychosocial factors. The withdrawal of some drugs can cause symptoms such as anxiety, psychosis, delirium, agitation or depression.
Advice for Travelers
The Medical Letter on Drugs and Therapeutics • April 15, 2002; (Issue 1128)
Patients planning to travel to other countries often ask physicians for advice about immunizations and prevention of diarrhea and malaria. More detailed advice for travelers is available from the CDC at...
Patients planning to travel to other countries often ask physicians for advice about immunizations and prevention of diarrhea and malaria. More detailed advice for travelers is available from the CDC at 877-FYI-TRIP (877-394-8747) or www.cdc.gov/travel.
Drugs that may cause Cognitive Disorders in the Elderly
The Medical Letter on Drugs and Therapeutics • November 27, 2000; (Issue 1093)
Older patients are especially susceptible to drug-induced cognitive impairment. They are more likely to be taking multiple drugs, to have higher blood levels of those drugs because of renal or hepatic...
Older patients are especially susceptible to drug-induced cognitive impairment. They are more likely to be taking multiple drugs, to have higher blood levels of those drugs because of renal or hepatic dysfunction, and to have pre-existing cognitive problems that make it difficult to detect the role of drugs causing new symptoms or making old ones worse.
Oral Contraceptives
The Medical Letter on Drugs and Therapeutics • May 15, 2000; (Issue 1078)
Two types of oral contraceptives are available in the USA: combination oral contraceptives that contain both an estrogen and a progestin, and progestin-only contraceptives, or "mini-pills."Used as directed, all...
Two types of oral contraceptives are available in the USA: combination oral contraceptives that contain both an estrogen and a progestin, and progestin-only contraceptives, or "mini-pills."Used as directed, all oral contraceptives marketed in the USA are similarly effective in preventing pregnancy.
Dofetilide for Atrial Fibrillation
The Medical Letter on Drugs and Therapeutics • May 15, 2000; (Issue 1078)
Dofetilide (Tikosyn - Pfizer), a new methanesulfonamide antiarrhythmic drug, has recently been marketed for oral treatment of atrial fibrillation and...
Dofetilide (Tikosyn - Pfizer), a new methanesulfonamide antiarrhythmic drug, has recently been marketed for oral treatment of atrial fibrillation and flutter.
Advice for Travelers
The Medical Letter on Drugs and Therapeutics • April 23, 1999; (Issue 1051)
Patients planning to travel to other countries often ask pysicians for advice about immunizations and prevention of diarrhea and malaria. Legal requirements for entry and epidemiological conditions in different...
Patients planning to travel to other countries often ask pysicians for advice about immunizations and prevention of diarrhea and malaria. Legal requirements for entry and epidemiological conditions in different countries vary from time to time, often unpredictably, but some reasonable recommendations can be made.
Cefdinir--A New Oral Cephalosporin
The Medical Letter on Drugs and Therapeutics • August 28, 1998; (Issue 1034)
Cefdinir (Omnicef - Parke-Davis), a third-generation oral cephalosporin, has been approved by the FDA for treatment of acute sinusitis, otitis media, acute exacerbations of chronic bronchitis, pharyngitis,...
Cefdinir (Omnicef - Parke-Davis), a third-generation oral cephalosporin, has been approved by the FDA for treatment of acute sinusitis, otitis media, acute exacerbations of chronic bronchitis, pharyngitis, community-acquired pneumonia and skin infections. Other drugs available for these indications are reviewed in The Medical Letter Handbook of Antimicrobial Therapy, 1998.
Topical Penciclovir for Herpes Labialis
The Medical Letter on Drugs and Therapeutics • June 20, 1997; (Issue 1003)
Penciclovir 1% cream (Denavir - SmithKline Beecham) has been approved by the US Food and Drug Administration (FDA) for treatment of recurrent orolabial herpes simplex virus (HSV) infections in adults....
Penciclovir 1% cream (Denavir - SmithKline Beecham) has been approved by the US Food and Drug Administration (FDA) for treatment of recurrent orolabial herpes simplex virus (HSV) infections in adults. Acyclovir (Zovirax) is also available in a topical formulation for treatment of herpes simplex infections, but is approved by the FDA only for use in immunocompromised patients. Oral drugs approved for treatment of some herpes simplex infections, but not recurrent orolabial infections, include acyclovir, valacyclovir (Valtrex) and famciclovir (Famvir), which is rapidly hydrolyzed to penciclovir in vivo (Medical Letter, 36:97, 1994).
Testosterone Patches for Hypogonadism
The Medical Letter on Drugs and Therapeutics • May 24, 1996; (Issue 975)
Men with primary or secondary hypogonadism require lifelong androgen replacement to prevent osteoporosis and maintain normal muscle mass, erythropoiesis and sexual function (AM Matsumoto, Endocrinol Metab...
Men with primary or secondary hypogonadism require lifelong androgen replacement to prevent osteoporosis and maintain normal muscle mass, erythropoiesis and sexual function (AM Matsumoto, Endocrinol Metab Clin North Am, 23:857, 1994). Until recently, the standard treatment for male hypogonadism has been an intramuscular injection of a long-acting testosterone ester every two to three weeks, which leads to serum testosterone concentrations that are high for a few days, normal for a few days more, and then may be subnormal until the next dose. Two transdermal preparations of testosterone are now marketed in the USA. Testoderm (Alza) must be worn on the scrotum. Androderm (SmithKline Beecham), a newer patch, can be applied to the upper arms, thighs, back or abdomen. All androgens are controlled substances in the USA.
Advice For Travelers
The Medical Letter on Drugs and Therapeutics • March 1, 1996; (Issue 969)
Patients planning to travel to other countries often ask physicians for advice about immunizations
and prevention of diarrhea and malaria. More detailed advice for travelers is
available from the CDC at...
Patients planning to travel to other countries often ask physicians for advice about immunizations
and prevention of diarrhea and malaria. More detailed advice for travelers is
available from the CDC at 877-FYI-TRIP (877-394-8747) or www.cdc.gov/travel.
Drugs for AIDS and Associated Infections
The Medical Letter on Drugs and Therapeutics • October 13, 1995; (Issue 959)
Results of recently completed clinical trials have led to some changes in recommendation for treatment of human immunodeficiency virus (HIV) and other infections associated with...
Results of recently completed clinical trials have led to some changes in recommendation for treatment of human immunodeficiency virus (HIV) and other infections associated with AIDS.
Advice For Travelers
The Medical Letter on Drugs and Therapeutics • May 13, 1994; (Issue 922)
...
Piperacillin/Tazobactam
The Medical Letter on Drugs and Therapeutics • January 21, 1994; (Issue 914)
Piperacillin/tazobactam (Zosyn - Lederle), an antibiotic combination product, has been approved by the US Food and Drug Administration for intravenous treatment of intra-abdominal, pelvic, skin, and...
Piperacillin/tazobactam (Zosyn - Lederle), an antibiotic combination product, has been approved by the US Food and Drug Administration for intravenous treatment of intra-abdominal, pelvic, skin, and skin-structure infections and for community-acquired pneumonia of moderate severity.
Drugs for AIDS and Associated infections
The Medical Letter on Drugs and Therapeutics • September 3, 1993; (Issue 904)
Results of recently completed clinical trials have led to some changes in recommendations for treatment of human immunodeficiency virus (HIV) and other infections associted with...
Results of recently completed clinical trials have led to some changes in recommendations for treatment of human immunodeficiency virus (HIV) and other infections associted with AIDS.
Atovaquone for Pneumocystis Carinii Pneumonia
The Medical Letter on Drugs and Therapeutics • April 2, 1993; (Issue 893)
Atovaquone (Mepron - Burroughs Wellcome), a hydroxynaphthoquinone, was recently approved by the US Food and Drug Administration (FDA) for oral treatment of mild to moderate Pneumocystis carinii pneumonia (PCP)...
Atovaquone (Mepron - Burroughs Wellcome), a hydroxynaphthoquinone, was recently approved by the US Food and Drug Administration (FDA) for oral treatment of mild to moderate Pneumocystis carinii pneumonia (PCP) in patients who cannot tolerate trimethoprim-sulfamethoxazole (Septra, Bactrim, and others). PCP is a common opportunistic infection and frequent cause of death in patients with AIDS.
Cefpodoxime Proxetil - A New Oral Cephalosporin
The Medical Letter on Drugs and Therapeutics • November 27, 1992; (Issue 884)
Cefpodoxime proxetil (Vantin - Upjohn), a new third-generation oral cephalosporin, has been approved for marketing by the US Food and Drug Administration. It is available for twice-daily treatment of...
Cefpodoxime proxetil (Vantin - Upjohn), a new third-generation oral cephalosporin, has been approved for marketing by the US Food and Drug Administration. It is available for twice-daily treatment of pharyngitis, upper and lower respiratory infections, otitis media, urinary tract infections, skin and soft tissue infections, and for single-dose treatment of uncomplicated gonorrhea in men or women and anorectal gonorrhea in women.
Enoxacin - A New Fluoroquinolone
The Medical Letter on Drugs and Therapeutics • November 13, 1992; (Issue 883)
Enoxacin (en ox' a sin; Penetrex - Rh ne-Poulenc Rorer), a fluoroquinolone antimicrobial for oral use, has now been marketed in the USA for treatment of urinary tract infections and uncomplicated urethral or...
Enoxacin (en ox' a sin; Penetrex - Rh ne-Poulenc Rorer), a fluoroquinolone antimicrobial for oral use, has now been marketed in the USA for treatment of urinary tract infections and uncomplicated urethral or cervical gonorrhea.
Loracarbef
The Medical Letter on Drugs and Therapeutics • September 18, 1992; (Issue 879)
Loracarbef (Lorabid - Lilly), a new beta-lactam antibiotic with antimicrobial activity similar to the second-generation cephalosporins, has been approved by the US Food and Drug Administration for treatment...
Loracarbef (Lorabid - Lilly), a new beta-lactam antibiotic with antimicrobial activity similar to the second-generation cephalosporins, has been approved by the US Food and Drug Administration for treatment of respiratory, skin, and urinary tract infection caused by susceptible organisms in both adults and children. It will probably compete with drugs such as trimethoprim-sulfamethoxazole (Bactrim, Septra, and others), amoxicillin-clavulanic acid (Augmentin), cefaclor (Ceclor), cefuroxime axetil (Ceftin), and cefprozil (Cefzil - Medical Letter, 34:63, 1992).
Cefprozil
The Medical Letter on Drugs and Therapeutics • June 26, 1992; (Issue 873)
Cefprozil (Cefzil - Bristol-Myers Squibb), a new oral second-generation cephalosporin, was recently released in the USA for treatment of pharyngitis, bronchitis, otitis media, and skin and skin-structure...
Cefprozil (Cefzil - Bristol-Myers Squibb), a new oral second-generation cephalosporin, was recently released in the USA for treatment of pharyngitis, bronchitis, otitis media, and skin and skin-structure infections.
Two New Fluoroquinolones
The Medical Letter on Drugs and Therapeutics • June 12, 1992; (Issue 872)
Temafloxacin (Omniflox - Abbott) and lomefloxacin (Maxaquin - Searle) are the latest fluoroquinolone antimicrobial agents to be approved by the US Food and Drug Administration (FDA) for oral treatment of...
Temafloxacin (Omniflox - Abbott) and lomefloxacin (Maxaquin - Searle) are the latest fluoroquinolone antimicrobial agents to be approved by the US Food and Drug Administration (FDA) for oral treatment of various infections. Previously marketed include norfloxacin (Noroxin - Medical Letter, 29:25, 1987), ciprofloxacin (Cipro - Medical Letter, 30:11, 1988), and ofloxacin (Floxin - Medical Letter, 33:71, 1991). Norfloxacin is marketed only for treatment of urinary tract infections, and lomefloxacin only for treatment of urinary tract infections and bronchitis known to be caused by Haemophilus influenzae or Moraxella catarrhalis. Ciprofloxacin and ofloxacin are also available in parenteral formulations.
Advice for Travelers
The Medical Letter on Drugs and Therapeutics • May 1, 1992; (Issue 869)
Patients planning to travel to other countries often ask physicians for advice about immunizations and prevention of diarrhea and malaria. Legal requirements for entry and epidemiological conditions in...
Patients planning to travel to other countries often ask physicians for advice about immunizations and prevention of diarrhea and malaria. Legal requirements for entry and epidemiological conditions in different countries vary from time to time, often unpredictably, but some reasonable recommendations can be made. More detailed information is available in Health Information for International Travel, published annually by the Centers for Disease Control (CDC), which can be obtained from the Superintendent of Documents, US Government Printing Office, Washington, DC 20402. Up-to-date automated information is available by telephone from the CDC (404-332-4559).
Prevention And Treatment of Cholera
The Medical Letter on Drugs and Therapeutics • November 15, 1991; (Issue 857)
Almost 300,000 cases of epidemic cholera have occurred in the Western Hemisphere in 1991, mostly in South and Central America (Morbid Mortal Weekly Rep, 40:562, Aug 16, 1991). The few US cases caused by the...
Almost 300,000 cases of epidemic cholera have occurred in the Western Hemisphere in 1991, mostly in South and Central America (Morbid Mortal Weekly Rep, 40:562, Aug 16, 1991). The few US cases caused by the epidemic strain have been in returning travelers or associated with contaminated food they brought back illicitly, with no secondary spread to date.
Drugs For AIDS And Associated Infections
The Medical Letter on Drugs and Therapeutics • October 18, 1991; (Issue 855)
A growing number of clinical trials now permits some consensus on the treatment of human immunodeficiency virus (HIV) and other infections associated with acquired immune deficiency syndrome (AIDS) in...
A growing number of clinical trials now permits some consensus on the treatment of human immunodeficiency virus (HIV) and other infections associated with acquired immune deficiency syndrome (AIDS) in adults.
Intravenous Ciprofloxacin
The Medical Letter on Drugs and Therapeutics • August 9, 1991; (Issue 850)
Ciprofloxacin, previously available orally (Cipro - Medical Letter, 30:11, 1988) and for ophthalmic use (Ciloxan - Medical Letter, 33:52, May 31, 1991), is now the first fluoroquinolone antibiotic to become...
Ciprofloxacin, previously available orally (Cipro - Medical Letter, 30:11, 1988) and for ophthalmic use (Ciloxan - Medical Letter, 33:52, May 31, 1991), is now the first fluoroquinolone antibiotic to become available in the USA in an intravenous (IV) formulation. Cipro I.V. (Miles) is being promoted as an alternative to third-generation cephalosporins, aminoglycosides, and other drugs used for treatment of serious infections.
Ofloxacin
The Medical Letter on Drugs and Therapeutics • July 26, 1991; (Issue 849)
Ofloxacin (Floxin - McNeil, Ortho), a new fluoroquinolone antibacterial agent, was recently marketed in the USA for oral treatment of various infections caused by susceptible microorganisms. Ofloxacin is the...
Ofloxacin (Floxin - McNeil, Ortho), a new fluoroquinolone antibacterial agent, was recently marketed in the USA for oral treatment of various infections caused by susceptible microorganisms. Ofloxacin is the third fluoroquinolone to become available in this country. Norfloxacin (Noroxin - Medical Letter, 29:25, 1987) is marketed only for treatment of urinary tract infections. Ciprofloxacin (Cipro - Medical Letter, 30:11, 1988), like ofloxacin, is approved for use in a variety of infections.
Choice of Cephalosporin
The Medical Letter on Drugs and Therapeutics • November 30, 1990; (Issue 832)
Since the last Medical Letter review of cephalosporin antibiotics (volume 25, page 57, 1983), many new cephalosporins have become available in the...
Since the last Medical Letter review of cephalosporin antibiotics (volume 25, page 57, 1983), many new cephalosporins have become available in the USA.
Pentamidine Aerosol To Prevent Pneumocystis Carinii Pneumonia
The Medical Letter on Drugs and Therapeutics • October 6, 1989; (Issue 802)
Pneumocystis carinii pneumonia (PCP) occurs in nearly 80% of patients with the acquired immune deficiency syndrome (AIDS) and is a common cause of morbidity and mortality. Oral trimethoprim-sulfamethoxazole...
Pneumocystis carinii pneumonia (PCP) occurs in nearly 80% of patients with the acquired immune deficiency syndrome (AIDS) and is a common cause of morbidity and mortality. Oral trimethoprim-sulfamethoxazole (Bactrim; and others), intravenous isethionate (Pentam 300) and other systemic drugs have been used to prevent PCP, but in AIDS patients, all of these agents can occasionally cause severe adverse effects (Medical Letter, 30:94, 1988). Recently, the US Food and Drug Administration approved marketing of aerosolized pentamidine isethionate (NebuPent - LyphoMed) for this indication. Another pentamidine aerosol (Pneumopent - Fisons) is available in Canada through the Emergency Drug Release Program.
Cefixime - A New Oral Cephalosporin
The Medical Letter on Drugs and Therapeutics • August 11, 1989; (Issue 798)
Cefixime (Suprax - Lederle), an oral cephalosporin antibiotic, was recently approved for marketing by the US Food and Drug Administration. Claimed to be the first oral third-generation cephalosporin, the new...
Cefixime (Suprax - Lederle), an oral cephalosporin antibiotic, was recently approved for marketing by the US Food and Drug Administration. Claimed to be the first oral third-generation cephalosporin, the new drug is offered for once-a-day treatment of otitis media, pharyngitis, bronchitis and urinary tract infections.
Trimetrexate
The Medical Letter on Drugs and Therapeutics • January 27, 1989; (Issue 784)
Trimetrexate glucuronate (Parke-Davis), an investigational drug, is now available in the USA from the National Institute of Allergy and Infectious Diseases (NIAID) for treatment of selected AIDS patients with...
Trimetrexate glucuronate (Parke-Davis), an investigational drug, is now available in the USA from the National Institute of Allergy and Infectious Diseases (NIAID) for treatment of selected AIDS patients with Pneumocystis carinii pneumonia (PCP). For this indication, trimetrexate is always used concurrently with leucovorin (Wellcovorin; and others).
Prevention of Pneumocystis Carinii Pneumonia
The Medical Letter on Drugs and Therapeutics • October 7, 1988; (Issue 776)
Pneumocystis carinii pneumonia (PCP) is a common cause of death in patients with acquired immune deficiency syndrome (AIDS). PCP is the first serious opportunistic infection in more than 60% of patients with...
Pneumocystis carinii pneumonia (PCP) is a common cause of death in patients with acquired immune deficiency syndrome (AIDS). PCP is the first serious opportunistic infection in more than 60% of patients with AIDS, and about 80% of AIDS patients develop PCP at least once (AE Glatt et al, N Engl J Med, 318:1439, June 2, 1988). Many studies using drugs to prevent PCP in patients with AIDS have recently been reported.
Penicillin Allergy
The Medical Letter on Drugs and Therapeutics • August 12, 1988; (Issue 772)
A penicillin is the drug of choice for treatment of many infections, but allergic reactions to these drugs occur frequently and, rarely, can be fatal. From 5% to 20% of patients have a history of a rash or...
A penicillin is the drug of choice for treatment of many infections, but allergic reactions to these drugs occur frequently and, rarely, can be fatal. From 5% to 20% of patients have a history of a rash or some other reaction while taking a penicillin, but maculopapular rashes with ampicillin or amoxicillin, especially in children with infectious mononucleosis, are probably not allergic.
Cefuroxime Axetil
The Medical Letter on Drugs and Therapeutics • June 3, 1988; (Issue 767)
Cefuroxime axetil (Ceftin - Glaxo), an oral form of the second-generation parenteral cephalosporin cefuroxime (Zinacef), was recently marketed in the USA. Previously available oral cephalosporins are the...
Cefuroxime axetil (Ceftin - Glaxo), an oral form of the second-generation parenteral cephalosporin cefuroxime (Zinacef), was recently marketed in the USA. Previously available oral cephalosporins are the first-generation drugs cephalexin (Keflex; and others), cephradine (Anspor; and others) and cefadroxil (Duricef; and others), and the second-generation cefaclor (Ceclor); second-generation cephalosporins have more activity against gram-negative bacteria.
Ciprofloxacin
The Medical Letter on Drugs and Therapeutics • January 29, 1988; (Issue 758)
Ciprofloxacin hydrochloride (Cipro - Miles), a synthetic antibacterial agent, was recently marketed in the USA for oral treatment of a wide variety of infections. Ciprofloxacin is the second fluoroquinolone...
Ciprofloxacin hydrochloride (Cipro - Miles), a synthetic antibacterial agent, was recently marketed in the USA for oral treatment of a wide variety of infections. Ciprofloxacin is the second fluoroquinolone to become available in this country; norfloxacin (Noroxin - Medical Letter, 29:25, 1987) is marketed only for treatment of urinary tract infections. Fluoroquinolones are more potent and have a much broader spectrum of activity than older quinolones such as nalidixic acid (NegGram).