Matching articles for "Flagyl"

Drugs for Rosacea

   
The Medical Letter on Drugs and Therapeutics • February 5, 2024;  (Issue 1695)
Rosacea is a common, chronic inflammatory facial eruption of unknown cause. It is more prevalent in women than in men, and disease onset typically occurs after age 30. Rosacea is characterized by erythema,...
Rosacea is a common, chronic inflammatory facial eruption of unknown cause. It is more prevalent in women than in men, and disease onset typically occurs after age 30. Rosacea is characterized by erythema, telangiectasia, and flushing, and sometimes by recurrent, progressive crops of acneiform papules and pustules, usually on the central part of the face. Some patients develop granulomas and tissue hypertrophy, which may lead to rhinophyma (a bulbous nose), particularly in men. Blepharitis and conjunctivitis are common. Keratitis and corneal scarring occur rarely.
Med Lett Drugs Ther. 2024 Feb 5;66(1695):21-2 | Show Full IntroductionHide Full Introduction

Treatment of Clostridioides difficile Infection

   
The Medical Letter on Drugs and Therapeutics • September 6, 2021;  (Issue 1632)
Clostridioides (formerly Clostridium) difficile infection (CDI) is the most common infectious cause of healthcare-associated diarrhea in adults. Guidelines on management of CDI have recently been...
Clostridioides (formerly Clostridium) difficile infection (CDI) is the most common infectious cause of healthcare-associated diarrhea in adults. Guidelines on management of CDI have recently been updated.
Med Lett Drugs Ther. 2021 Sep 6;63(1632):137-41 | Show Full IntroductionHide Full Introduction

Secnidazole (Solosec) for Bacterial Vaginosis

   
The Medical Letter on Drugs and Therapeutics • March 26, 2018;  (Issue 1543)
The FDA has approved secnidazole oral granules (Solosec – Symbiomix/Lupin) for single-dose treatment of bacterial vaginosis (BV) in adult...
The FDA has approved secnidazole oral granules (Solosec – Symbiomix/Lupin) for single-dose treatment of bacterial vaginosis (BV) in adult women.
Med Lett Drugs Ther. 2018 Mar 26;60(1543):52-3 | Show Full IntroductionHide Full Introduction

Drugs for GERD and Peptic Ulcer Disease

   
The Medical Letter on Drugs and Therapeutics • January 15, 2018;  (Issue 1538)
Gastroesophageal reflux disease (GERD) is the most frequent GI condition encountered in the outpatient setting; it affects about 20% of the US population. Heartburn and regurgitation are the classic...
Gastroesophageal reflux disease (GERD) is the most frequent GI condition encountered in the outpatient setting; it affects about 20% of the US population. Heartburn and regurgitation are the classic symptoms of GERD.
Med Lett Drugs Ther. 2018 Jan 15;60(1538):9-16 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 2017 Oct 23;59(1532):171-7 | Show Full IntroductionHide Full Introduction

Drugs for Helicobacter pylori Infection

   
The Medical Letter on Drugs and Therapeutics • July 17, 2017;  (Issue 1525)
About 50% of the world’s population is infected with Helicobacter pylori. These gastric bacteria can cause chronic inflammation and have been associated with development of gastritis, peptic ulcer disease,...
About 50% of the world’s population is infected with Helicobacter pylori. These gastric bacteria can cause chronic inflammation and have been associated with development of gastritis, peptic ulcer disease, gastric adenocarcinoma, and gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Eradication of H. pylori can promote gastric healing, prevent recurrence of duodenal and gastric ulcers, and reduce the incidence of gastric cancer. Guidelines for treatment of H. pylori infection were updated recently.
Med Lett Drugs Ther. 2017 Jul 17;59(1525):113-7 | Show Full IntroductionHide Full Introduction

Drugs for Sexually Transmitted Infections

   
The Medical Letter on Drugs and Therapeutics • July 3, 2017;  (Issue 1524)
The text and tables that follow include recommendations for management of sexually transmitted infections (STIs) other than HIV and viral hepatitis. Some of the indications and dosages recommended here have...
The text and tables that follow include recommendations for management of sexually transmitted infections (STIs) other than HIV and viral hepatitis. Some of the indications and dosages recommended here have not been approved by the FDA.
Med Lett Drugs Ther. 2017 Jul 3;59(1524):105-12 | Show Full IntroductionHide Full Introduction

Bezlotoxumab (Zinplava) for Prevention of Recurrent Clostridium difficile Infection

   
The Medical Letter on Drugs and Therapeutics • March 27, 2017;  (Issue 1517)
The FDA has approved the fully human monoclonal antibody bezlotoxumab (Zinplava – Merck) for use with antibacterial drug treatment to reduce recurrence of Clostridium difficile infection (CDI) in adults...
The FDA has approved the fully human monoclonal antibody bezlotoxumab (Zinplava – Merck) for use with antibacterial drug treatment to reduce recurrence of Clostridium difficile infection (CDI) in adults with CDI at high risk for recurrence. It is the first drug to be approved for this indication.
Med Lett Drugs Ther. 2017 Mar 27;59(1517):49-50 | Show Full IntroductionHide Full Introduction

Antimicrobial Prophylaxis for Surgery

   
The Medical Letter on Drugs and Therapeutics • May 23, 2016;  (Issue 1495)
Antimicrobial prophylaxis can decrease the incidence of postoperative surgical site infection after some procedures. Since the last Medical Letter article on this subject, consensus guidelines have been...
Antimicrobial prophylaxis can decrease the incidence of postoperative surgical site infection after some procedures. Since the last Medical Letter article on this subject, consensus guidelines have been published. Recommendations for prophylaxis in specific surgical procedures are listed in Table 1.
Med Lett Drugs Ther. 2016 May 23;58(1495):63-8 | Show Full IntroductionHide Full Introduction

Drugs for Rosacea

   
The Medical Letter on Drugs and Therapeutics • February 1, 2016;  (Issue 1487)
This common, chronic inflammatory facial eruption of unknown cause is more prevalent in women than in men. Rosacea is characterized by erythema and telangiectasia, and sometimes by recurrent, progressive...
This common, chronic inflammatory facial eruption of unknown cause is more prevalent in women than in men. Rosacea is characterized by erythema and telangiectasia, and sometimes by recurrent, progressive crops of acneiform papules and pustules, usually on the central part of the face. Some patients develop granulomas and tissue hypertrophy, which may lead to rhinophyma (a bulbous nose), particularly in men. Blepharitis and conjunctivitis are common. Keratitis and corneal scarring occur rarely.
Med Lett Drugs Ther. 2016 Feb 1;58(1487):16-7 | Show Full IntroductionHide Full Introduction

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).
Med Lett Drugs Ther. 2014 Aug 4;56(1448):65-72 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 2014 Jul 7;56(1446):53-8 | Show Full IntroductionHide Full Introduction

Drugs for Peptic Ulcer Disease and GERD

   
The Medical Letter on Drugs and Therapeutics • April 1, 2014;  (Issue 140)
H2-RECEPTOR ANTAGONISTS (H2RAs) — Currently available H2RAs are listed in Table 1. These drugs inhibit the action of histamine at the H2-receptor of the gastric parietal cell, decreasing basal acid...
H2-RECEPTOR ANTAGONISTS (H2RAs) — Currently available H2RAs are listed in Table 1. These drugs inhibit the action of histamine at the H2-receptor of the gastric parietal cell, decreasing basal acid secretion and, to a lesser degree, food-stimulated acid secretion. All H2RAs are about equally effective for treatment of PUD and GERD. H2RAs are faster acting than PPIs in relieving symptoms of dyspepsia or GERD, but they are not as effective as PPIs in relieving symptoms or in healing erosive esophagitis. Repeated administration of H2RAs leads to pharmacologic tolerance and has been associated with the development of new dyspeptic symptoms. Rebound acid hypersecretion can occur after stopping H2RAs.
Treat Guidel Med Lett. 2014 Apr;12(140):25-30 | Show Full IntroductionHide Full Introduction

Drugs for Sexually Transmitted Infections

   
The Medical Letter on Drugs and Therapeutics • September 1, 2013;  (Issue 133)
Many infections can be transmitted during sexual contact. The text and tables that follow include recommendations for management of sexually transmitted infections (STIs) other than HIV, viral hepatitis,...
Many infections can be transmitted during sexual contact. The text and tables that follow include recommendations for management of sexually transmitted infections (STIs) other than HIV, viral hepatitis, and enteric infections. Some of the indications and dosages recommended here have not been approved by the FDA.
Treat Guidel Med Lett. 2013 Sep;11(133):87-94 | Show Full IntroductionHide Full Introduction

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.
Treat Guidel Med Lett. 2013 Jul;11(131):65-74 | Show Full IntroductionHide Full Introduction

Antimicrobial Prophylaxis for Surgery

   
The Medical Letter on Drugs and Therapeutics • October 1, 2012;  (Issue 122)
Antimicrobial prophylaxis can decrease the incidence of postoperative infection, particularly surgical site infection, after some procedures. Recommendations for such prophylaxis are listed in the table that...
Antimicrobial prophylaxis can decrease the incidence of postoperative infection, particularly surgical site infection, after some procedures. Recommendations for such prophylaxis are listed in the table that begins on page 74. Antimicrobial prophylaxis for dental procedures to prevent endocarditis was recently discussed in The Medical Letter.
Treat Guidel Med Lett. 2012 Oct;10(122):73-8 | Show Full IntroductionHide Full Introduction

Drugs for Inflammatory Bowel Disease

   
The Medical Letter on Drugs and Therapeutics • March 1, 2012;  (Issue 115)
Inflammatory bowel disease (IBD) is generally classified as either Crohn’s disease (CD) or ulcerative colitis (UC). More detailed guidelines on their treatment are available from the American College...
Inflammatory bowel disease (IBD) is generally classified as either Crohn’s disease (CD) or ulcerative colitis (UC). More detailed guidelines on their treatment are available from the American College of Gastroenterology.
Treat Guidel Med Lett. 2012 Mar;10(115):19-28 | Show Full IntroductionHide Full Introduction

Fidaxomicin (Dificid) for Clostridium Difficile Infection

   
The Medical Letter on Drugs and Therapeutics • September 19, 2011;  (Issue 1373)
The FDA has approved fidaxomicin (Dificid – Optimer), a new oral macrolide antibiotic, for treatment of Clostridium difficile-associated diarrhea in patients ≥18 years old. The incidence and severity of...
The FDA has approved fidaxomicin (Dificid – Optimer), a new oral macrolide antibiotic, for treatment of Clostridium difficile-associated diarrhea in patients ≥18 years old. The incidence and severity of C. difficile infection (CDI) have increased in recent years with the emergence of an epidemic hypervirulent strain (NAP1/B1/027), possibly related to widespread use of fluoroquinolones.
Med Lett Drugs Ther. 2011 Sep 19;53(1373):73-4 | Show Full IntroductionHide Full Introduction

Drugs for Peptic Ulcer Disease and GERD

   
The Medical Letter on Drugs and Therapeutics • September 1, 2011;  (Issue 109)
Peptic ulcer disease (PUD) is usually caused by nonsteroidal anti-inflammatory drugs (NSAIDs) or by infection with Helicobacter pylori. Gastroesophageal reflux disease (GERD) can be caused by...
Peptic ulcer disease (PUD) is usually caused by nonsteroidal anti-inflammatory drugs (NSAIDs) or by infection with Helicobacter pylori. Gastroesophageal reflux disease (GERD) can be caused by transient lower esophageal sphincter relaxation, reduced lower esophageal sphincter tone, hiatal hernia, delayed gastric emptying or hormonal changes due to pregnancy. Acid suppressive therapy is the cornerstone of management for both PUD and GERD.
Treat Guidel Med Lett. 2011 Sep;9(109):55-60 | Show Full IntroductionHide Full Introduction

Treatment of Clostridium Difficile Infection

   
The Medical Letter on Drugs and Therapeutics • February 21, 2011;  (Issue 1358)
Clostridium difficile infection (CDI) is the most common infectious cause of healthcare-associated diarrhea in adults. The incidence and severity of CDI have increased in recent years with the emergence of an...
Clostridium difficile infection (CDI) is the most common infectious cause of healthcare-associated diarrhea in adults. The incidence and severity of CDI have increased in recent years with the emergence of an epidemic virulent strain (NAP1/BI/027). Common risk factors include admission to a healthcare facility, increasing age and severity of underlying illness, gastric acid suppression and exposure to antimicrobials, particularly clindamycin, ampicillin, cephalosporins or fluoroquinolones. Patients who develop CDI while receiving a precipitating antibiotic should have the antibiotic discontinued, if possible, or switched to another appropriate antimicrobial with a lower risk of CDI.
Med Lett Drugs Ther. 2011 Feb 21;53(1358):14-6 | Show Full IntroductionHide Full Introduction

Rifaximin (Xifaxan 550) for Hepatic Encephalopathy

   
The Medical Letter on Drugs and Therapeutics • November 1, 2010;  (Issue 1350)
The FDA has approved a new 550-mg tablet of rifaximin (Xifaxan – Salix), a minimally absorbed oral antibiotic, to reduce the risk of recurrent hepatic encephalopathy (HE). A 200-mg tablet has been...
The FDA has approved a new 550-mg tablet of rifaximin (Xifaxan – Salix), a minimally absorbed oral antibiotic, to reduce the risk of recurrent hepatic encephalopathy (HE). A 200-mg tablet has been available for treatment of travelers’ diarrhea since 2004.
Med Lett Drugs Ther. 2010 Nov 1;52(1350):87 | Show Full IntroductionHide Full Introduction

Drugs for Sexually Transmitted Infections

   
The Medical Letter on Drugs and Therapeutics • July 1, 2010;  (Issue 95)
Many infections can be transmitted during sexual contact. The text and tables that follow are limited to management of sexually transmitted infections (STIs) other than HIV, viral hepatitis and enteric...
Many infections can be transmitted during sexual contact. The text and tables that follow are limited to management of sexually transmitted infections (STIs) other than HIV, viral hepatitis and enteric infections. The drugs of choice, their dosages and alternatives are listed in a table that begins on page 54. A table listing the adverse effects of some of these antimicrobials begins on page 58.
Treat Guidel Med Lett. 2010 Jul;8(95):53-60 | Show Full IntroductionHide Full Introduction

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.
Treat Guidel Med Lett. 2010 Jun;8(94):43-52 | Show Full IntroductionHide Full Introduction

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.
Treat Guidel Med Lett. 2009 Sep;7(85):65-74 | Show Full IntroductionHide Full Introduction

Antimicrobial Prophylaxis for Surgery

   
The Medical Letter on Drugs and Therapeutics • June 1, 2009;  (Issue 82)
Antimicrobial prophylaxis can decrease the incidence of infection, particularly surgical site infection, after certain procedures. Recommendations for prevention of surgical site infection are listed in the...
Antimicrobial prophylaxis can decrease the incidence of infection, particularly surgical site infection, after certain procedures. Recommendations for prevention of surgical site infection are listed in the table that begins on page 48. Antimicrobial prophylaxis for dental procedures to prevent endocarditis is discussed in The Medical Letter 2007; 49:99.
Treat Guidel Med Lett. 2009 Jun;7(82):47-52 | Show Full IntroductionHide Full Introduction

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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Med Lett Drugs Ther. 2008 Dec 15;50(1301):100-3 | Show Full IntroductionHide Full Introduction

Treatment of Peptic Ulcers and GERD

   
The Medical Letter on Drugs and Therapeutics • August 1, 2008;  (Issue 72)
Peptic ulcers caused by treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) are mainly gastric ulcers. Most duodenal and other gastric ulcers are caused by the gram-negative bacillus Helicobacter...
Peptic ulcers caused by treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) are mainly gastric ulcers. Most duodenal and other gastric ulcers are caused by the gram-negative bacillus Helicobacter pylori. Gastroesophageal reflux disease (GERD) is caused by gastric acid reflux into the esophagus. Drugs that suppress gastric acid production are the primary treatment for GERD and peptic ulcers.
Treat Guidel Med Lett. 2008 Aug;6(72):55-60 | Show Full IntroductionHide Full Introduction

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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Med Lett Drugs Ther. 2008 Jun 16;50(1288):45 | Show Full IntroductionHide Full Introduction

Correction: Natalizumab (Tysabri) for Crohn's Disease

   
The Medical Letter on Drugs and Therapeutics • June 2, 2008;  (Issue 1287)
The May 5, 2008 article (Med Lett Drugs Ther 2008; 50:34) on the approval of natalizumab (Tysabri) for treatment of Crohn's disease in the "Adverse Effects" section on page 35 included the statement:...
The May 5, 2008 article (Med Lett Drugs Ther 2008; 50:34) on the approval of natalizumab (Tysabri) for treatment of Crohn's disease in the "Adverse Effects" section on page 35 included the statement: "post-marketing hepatotoxicity, sometimes fatal or requiring liver transplantation, has occurred." Actually, no fatal hepatotoxicity or liver transplantation has been reported to date. The FDA warning about post-marketing hepatotoxicity with Tysabri that was the basis for our statement said: "The combination of transaminase elevations and elevated bilirubin without evidence of obstruction is recognized as an important predictor of severe liver injury that may lead to [emphasis added] death or the need for a liver transplant in some patients." Also, in the last sentence of the Conclusion, we should have said: "Because of the risk of serious hepatic toxicity and the rare but even more serious risk of developing progressive multifocal leukoencephalopathy, it should be used only in patients who have not responded to other drugs, including a TNF inhibitor." The italicized words should be substituted for "it is FDA-approved for use."

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Med Lett Drugs Ther. 2008 Jun 2;50(1287):44 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 2008 May 19;50(1286):39-40 | Show Full IntroductionHide Full Introduction

Natalizumab (Tysabri) for Crohn's Disease

   
The Medical Letter on Drugs and Therapeutics • May 5, 2008;  (Issue 1285)
Natalizumab (Tysabri - Elan and Biogen) is a monoclonal antibody approved for induction and maintenance treatment of moderate to severe Crohn's disease (CD) refractory to conventional therapies and inhibitors...
Natalizumab (Tysabri - Elan and Biogen) is a monoclonal antibody approved for induction and maintenance treatment of moderate to severe Crohn's disease (CD) refractory to conventional therapies and inhibitors of tumor necrosis factor (TNF). Initially approved in 2004 for the treatment of multiple sclerosis (MS), natalizumab was temporarily withdrawn from the market after 3 patients developed progressive multifocal leukoencephalopathy (PML). It is now available for treatment of both MS and CD through a restricted distribution program.
Med Lett Drugs Ther. 2008 May 5;50(1285):34-6 | Show Full IntroductionHide Full Introduction

Tinidazole (Tindamax) - A New Option for Treatment of Bacterial Vaginosis

   
The Medical Letter on Drugs and Therapeutics • September 10, 2007;  (Issue 1269)
Tinidazole (Tindamax - Mission Pharmacal), an oral antiprotozoal drug available in the US since 2004 for treatment of trichomoniasis, giardiasis, amebiasis and amebic liver abscess, was recently approved by the...
Tinidazole (Tindamax - Mission Pharmacal), an oral antiprotozoal drug available in the US since 2004 for treatment of trichomoniasis, giardiasis, amebiasis and amebic liver abscess, was recently approved by the FDA for treatment of bacterial vaginosis.
Med Lett Drugs Ther. 2007 Sep 10;49(1269):73-4 | Show Full IntroductionHide Full Introduction

Drugs for Sexually Transmitted Infections

   
The Medical Letter on Drugs and Therapeutics • September 1, 2007;  (Issue 61)
Many infections can be transmitted during sexual contact. The text and tables that follow are limited to management of sexually transmitted infections (STIs) other than HIV, viral hepatitis and enteric...
Many infections can be transmitted during sexual contact. The text and tables that follow are limited to management of sexually transmitted infections (STIs) other than HIV, viral hepatitis and enteric infections. Guidelines are available from the US Centers for Disease Control and Prevention (CDC) with detailed recommendations for treatment of these diseases.
Treat Guidel Med Lett. 2007 Sep;5(61):81-9 | Show Full IntroductionHide Full Introduction

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.
Treat Guidel Med Lett. 2007 May;5(57):33-50 | Show Full IntroductionHide Full Introduction

Antimicrobial Prophylaxis for Surgery

   
The Medical Letter on Drugs and Therapeutics • December 1, 2006;  (Issue 52)
Antimicrobial prophylaxis can decrease the incidence of infection, particularly surgical site infection, after certain procedures. Recommendations for prevention of surgical site infection are listed in this...
Antimicrobial prophylaxis can decrease the incidence of infection, particularly surgical site infection, after certain procedures. Recommendations for prevention of surgical site infection are listed in this article.
Treat Guidel Med Lett. 2006 Dec;4(52):83-8 | Show Full IntroductionHide Full Introduction

Treatment of Clostridium difficile-Associated Disease (CDAD)

   
The Medical Letter on Drugs and Therapeutics • November 6, 2006;  (Issue 1247)
The gram-positive anaerobic bacillus Clostridium difficile is the most common identifiable cause of antibiotic-associated diarrhea. The antibiotics most often implicated have been ampicillin, second and third...
The gram-positive anaerobic bacillus Clostridium difficile is the most common identifiable cause of antibiotic-associated diarrhea. The antibiotics most often implicated have been ampicillin, second and third generation cephalosporins, clindamycin and fluoroquinolones. The emergence in recent years of a new, more toxic epidemic strain (BI/NAP1), possibly related to widespread use of fluoroquinolones, has caused a marked increase in the incidence and severity of C. difficile-associated disease (CDAD).
Med Lett Drugs Ther. 2006 Nov 6;48(1247):89-90 | Show Full IntroductionHide Full Introduction

Drugs for Acne, Rosacea and Psoriasis

   
The Medical Letter on Drugs and Therapeutics • July 1, 2005;  (Issue 35)
The pathogenesis of acne is multifactorial: follicular hyperkeratinization, Propionibacterium acnes bacteria, sebum production, androgens and inflammation have all been implicated. P. acnes, a gram-positive...
The pathogenesis of acne is multifactorial: follicular hyperkeratinization, Propionibacterium acnes bacteria, sebum production, androgens and inflammation have all been implicated. P. acnes, a gram-positive microaerophilic bacterium, plays an important role in the development of acne lesions by secreting chemotactic factors that attract leukocytes to the follicle, causing inflammation.
Treat Guidel Med Lett. 2005 Jul;3(35):49-56 | Show Full IntroductionHide Full Introduction

Drugs for Sexually Transmitted Infections

   
The Medical Letter on Drugs and Therapeutics • October 1, 2004;  (Issue 26)
Many infections can be transmitted during sexual contact. The text and tables that follow are limited to management of sexually transmitted infections (STIs) other than HIV, viral hepatitis and enteric...
Many infections can be transmitted during sexual contact. The text and tables that follow are limited to management of sexually transmitted infections (STIs) other than HIV, viral hepatitis and enteric infections. Guidelines are available from the US Centers for Disease Control and Prevention (CDC) with detailed recommendations for treatment of these diseases (MMWR Recomm Rep 2002; 51, RR-6:1). New guidelines are expected soon.
Treat Guidel Med Lett. 2004 Oct;2(26):67-74 | Show Full IntroductionHide Full Introduction

Tinidazole (Tindamax) - A New Anti-Protozoal Drug

   
The Medical Letter on Drugs and Therapeutics • August 30, 2004;  (Issue 1190)
Tinidazole (Tindamax - Presutti Labs), an oral antiprotozoal drug similar to metronidazole (Flagyl, and others), has been approved by the FDA for treatment of trichomoniasis in adults and for treatment of...
Tinidazole (Tindamax - Presutti Labs), an oral antiprotozoal drug similar to metronidazole (Flagyl, and others), has been approved by the FDA for treatment of trichomoniasis in adults and for treatment of giardiasis, intestinal amebiasis and amebic liver abcess in adults and children more than 3 years old. Tinidazole has been widely used outside of the US for decades under the trade name Fasigyn (Pfizer).
Med Lett Drugs Ther. 2004 Aug 30;46(1190):70-2 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 2004 Aug 16;46(1189):66 | Show Full IntroductionHide Full Introduction

Antimicrobial Prophylaxis for Surgery

   
The Medical Letter on Drugs and Therapeutics • April 1, 2004;  (Issue 20)
Antimicrobial prophylaxis can decrease the incidence of infection, particularly surgical site infection, after certain operations, but this benefit must be weighed against the risks of toxic and allergic...
Antimicrobial prophylaxis can decrease the incidence of infection, particularly surgical site infection, after certain operations, but this benefit must be weighed against the risks of toxic and allergic reactions, emergence of resistant bacteria, adverse drug interactions, superinfection and cost. Medical Letter consultants generally recommend antimicrobial prophylaxis only for procedures with high infection rates, those involving implantation of prosthetic material, and those in which the consequences of infection are likely to be especially serious.
Treat Guidel Med Lett. 2004 Apr;2(20):27-32 | Show Full IntroductionHide Full Introduction

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.
Treat Guidel Med Lett. 2004 Mar;2(19):13-22 | Show Full IntroductionHide Full Introduction

Drugs for Peptic Ulcers

   
The Medical Letter on Drugs and Therapeutics • February 1, 2004;  (Issue 18)
Most peptic ulcers not caused by nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with infection of the gastric mucosa by the gram-negative bacilli Helicobacter pylori. The majority of NSAID-related...
Most peptic ulcers not caused by nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with infection of the gastric mucosa by the gram-negative bacilli Helicobacter pylori. The majority of NSAID-related ulcers are gastric. H. pylori infection causes both duodenal and gastric ulcers. Eradication of H. pylori promotes healing and markedly decreases recurrence of both duodenal and gastric ulcers (A Shiotamni and DY Graham, Med Clin North Am 2002; 86:1447; FKL Chan and WK Leung, Lancet 2002; 360:933). The first step in the management of peptic ulcers is the diagnosis and treatment of H. pylori.
Treat Guidel Med Lett. 2004 Feb;2(18):7-12 | Show Full IntroductionHide Full Introduction

Drugs for Pneumonia

   
The Medical Letter on Drugs and Therapeutics • September 1, 2003;  (Issue 13)
The choice of drugs for treatment of pneumonia depends on the most likely pathogens causing the infection and local antimicrobial resistance patterns. Factors such as severity of illness, presence of co-morbid...
The choice of drugs for treatment of pneumonia depends on the most likely pathogens causing the infection and local antimicrobial resistance patterns. Factors such as severity of illness, presence of co-morbid conditions and whether the infection is community or hospital-acquired also need to be considered.
Treat Guidel Med Lett. 2003 Sep;1(13):83-8 | Show Full IntroductionHide Full Introduction

Nitazoxanide (Alinia) -- a New Anti-protozoal Agent

   
The Medical Letter on Drugs and Therapeutics • April 14, 2003;  (Issue 1154)
Nitazoxanide (Alinia - Romark Labs), a new antiparasitic drug, has been approved by the FDA in a liquid formulation for treatment of diarrhea caused by Cryptosporidium parvum and Giardia lamblia in children 1...
Nitazoxanide (Alinia - Romark Labs), a new antiparasitic drug, has been approved by the FDA in a liquid formulation for treatment of diarrhea caused by Cryptosporidium parvum and Giardia lamblia in children 1 to 11 years old. It is the first drug approved for treatment of cryptosporidiosis and the first to become available as a liquid for treatment of giardiasis. The FDA is reviewing a tablet formulation of nitazoxanide for use in adults.
Med Lett Drugs Ther. 2003 Apr 14;45(1154):29-31 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 2002 Jul 8;44(1134):59-62 | Show Full IntroductionHide Full Introduction

Drugs for Parasitic Infections

   
The Medical Letter on Drugs and Therapeutics • April 1, 2002;  (Issue 1127)
Superseded--purchase updated Parasitic Infections articleParasitic infections are found throughout the world. With increasing travel, immigration, use of immunosuppressive drugs and the spread of AIDS,...
Superseded--purchase updated Parasitic Infections article
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.

Note: Drugs for Parasitic Infections, revised and updated, is now available to both subscribers and nonsubscribers on our web site. This article, a bi-annual feature of The Medical Letter for many years, will not be published as a printed issue in 2002, but is included in the 16th edition of The Medical Letter Handbook of Antimicrobial Therapy. The handbook is now available and can be ordered by calling customer service at 1-800-211-2769.
Med Lett Drugs Ther. 2002 Apr 1;44(1127):32 | Show Full IntroductionHide Full Introduction

Budesonide (Entocort EC) For Crohn's Disease

   
The Medical Letter on Drugs and Therapeutics • January 21, 2002;  (Issue 1122)
Budesonide (Entocort EC — AstraZeneca), a locally active glucocorticosteriod widely used for inhalation treatment of allergic rhinitis and asthma (Medical Letter 2000; 42:19), has been approved for oral...
Budesonide (Entocort EC — AstraZeneca), a locally active glucocorticosteriod widely used for inhalation treatment of allergic rhinitis and asthma (Medical Letter 2000; 42:19), has been approved for oral treatment of mild to moderate active Crohn's disease involving the ileum and/or ascending colon. Both oral budesonide and budesonide enemas have been available for years in Europe and Canada for treatment of inflammatory bowel disease.
Med Lett Drugs Ther. 2002 Jan 21;44(1122):6-8 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 2000 Nov 27;42(1093):111-2 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 2000 May 15;42(1078):42-4 | Show Full IntroductionHide Full Introduction

Drugs for Sexually Transmitted Infections

   
The Medical Letter on Drugs and Therapeutics • September 24, 1999;  (Issue 1062)
Many infections can be transmitted during sexual contact. The text and tables [in this article] are limited to treatment of non-HIV infections associated primarily with sexual...
Many infections can be transmitted during sexual contact. The text and tables [in this article] are limited to treatment of non-HIV infections associated primarily with sexual transmission.
Med Lett Drugs Ther. 1999 Sep 24;41(1062):85-90 | Show Full IntroductionHide Full Introduction

Drugs for Treatment of Peptic Ulcers

   
The Medical Letter on Drugs and Therapeutics • January 3, 1997;  (Issue 991)
Most peptic ulcers not caused by nonsteroidal anti-inflammatory drugs (NSAIDs) are now thought to be associated with infection of the gastric mucosa by the gram-negative bacilli Helicobacter pylori. The...
Most peptic ulcers not caused by nonsteroidal anti-inflammatory drugs (NSAIDs) are now thought to be associated with infection of the gastric mucosa by the gram-negative bacilli Helicobacter pylori. The majority of NSAID-related ulcers are gastric. H. pylori have been associated with both duodenal and gastric ulcers. Eradication of H. pylori promotes healing and markedly decreases recurrence of both duodenal and gastric ulcers (AH Soll, JAMA, 275:622, 1996).
Med Lett Drugs Ther. 1997 Jan 3;39(991):1-4 | Show Full IntroductionHide Full Introduction

Meropenem - A New Parenteral Broad-Spectrum Antibiotic

   
The Medical Letter on Drugs and Therapeutics • September 27, 1996;  (Issue 984)
Meropenem (Merrem - Zeneca), a carbapenem similar to imipenem-cilastatin (Primaxin), has been approved by the US Food and Drug Administration for intravenous (IV) treatment of complicated intra-abdominal...
Meropenem (Merrem - Zeneca), a carbapenem similar to imipenem-cilastatin (Primaxin), has been approved by the US Food and Drug Administration for intravenous (IV) treatment of complicated intra-abdominal infections in adults and children and bacterial meningitis in children more than three months old. Imipenem (Medical Letter, 28:29, 1986) has been useful for treatment of serious infections in which broad coverage of nosocomial organisms, including anaerobes, is needed. Other drugs for these indications were reviewed in the Medical Letter article on 'The Choice of Antibacterial Drugs' (volume 38, page 25, March 29, 1996).
Med Lett Drugs Ther. 1996 Sep 27;38(984):88-90 | Show Full IntroductionHide Full Introduction

Drugs for Treatment of Peptic Ulcers

   
The Medical Letter on Drugs and Therapeutics • July 22, 1994;  (Issue 927)
Most peptic ulcers not caused by nonsteroidal anti-inflammatory drugs (NSAIDs) are now thought to be associated with infection of the gastric mucosa by the gram-negative bacilli Helicobacter pylori (NIH...
Most peptic ulcers not caused by nonsteroidal anti-inflammatory drugs (NSAIDs) are now thought to be associated with infection of the gastric mucosa by the gram-negative bacilli Helicobacter pylori (NIH Consensus Development Panel, JAMA, 272:65, July 6, 1994). NSAID-related ulcers are usually gastric. H. pylori have been associated with both duodenal and gastric ulcers.
Med Lett Drugs Ther. 1994 Jul 22;36(927):65-7 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 1994 Jan 21;36(914):7-8 | Show Full IntroductionHide Full Introduction

Topical Treatment for Bacterial Vaginosis

   
The Medical Letter on Drugs and Therapeutics • November 27, 1992;  (Issue 884)
A 0.75% vaginal gel formulation of metronidazole (MetroGel-Vaginal - Curatek) and a 2% vaginal cream formulation of clindamycin phosphate (Cleocin - Upjohn) were recently approved by the US Food and Drug...
A 0.75% vaginal gel formulation of metronidazole (MetroGel-Vaginal - Curatek) and a 2% vaginal cream formulation of clindamycin phosphate (Cleocin - Upjohn) were recently approved by the US Food and Drug Administration for treatment of bacterial vaginosis. Seven days' treatment with oral metronidazole, 500 mg b.i.d., has been the usual treatment for this condition, with oral clindamycin, 300 mg b.i.d., as an alternative (JL Thomason et al, Am J Obstet Gynecol, 165:1210, 1991).
Med Lett Drugs Ther. 1992 Nov 27;34(884):109-10 | Show Full IntroductionHide Full Introduction

Drugs For Treatment of Peptic Ulcers

   
The Medical Letter on Drugs and Therapeutics • November 29, 1991;  (Issue 858)
Drugs that accelerate healing and prevent relapse or reurrence of peptic ulcers act either by decreasing gastric acidity or by enhancing mucosal defense mechanisms. Risk factors that may cause breakdown of...
Drugs that accelerate healing and prevent relapse or reurrence of peptic ulcers act either by decreasing gastric acidity or by enhancing mucosal defense mechanisms. Risk factors that may cause breakdown of mucosal defenses include the use of aspirinor other nonsteroidal anti-inflammatory drugs (NSAIDs) and the presence of Helicobacter pylori bacterial in the gastric antrum (AH Soll, Engl J Med, 322:909, 1990; WL Peterson, N Engl J Med, 324:1043, 1991).
Med Lett Drugs Ther. 1991 Nov 29;33(858):111-4 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 1990 Nov 30;32(832):107-10 | Show Full IntroductionHide Full Introduction

Treatment of Clostridium Difficile Diarrhea

   
The Medical Letter on Drugs and Therapeutics • October 20, 1989;  (Issue 803)
The gram-positive bacillus Clostridium difficile is the most common identifiable cause of antibiotic-associated diarrhea and pseudomembranous colitis (R Fekety in GL Mandell et al, eds, Principles and...
The gram-positive bacillus Clostridium difficile is the most common identifiable cause of antibiotic-associated diarrhea and pseudomembranous colitis (R Fekety in GL Mandell et al, eds, Principles and Practice of Infectious Diseases, 3rd ed, New York:Churchill Livingstone, 1990, page 863). C. difficile colitis usually develops during or soon after antibiotic treatment. Virtually any antimicrobial agent can cause the disorder, but clindamycin, ampicillin and the cephalosporins have been implicated most frequently. Pseudomembranous colitis was recently reported in five patients who had each taken only a single dose of a cephalosporin (JP Freiman et al, JAMA, 262:902, August 18, 1989).
Med Lett Drugs Ther. 1989 Oct 20;31(803):94-5 | Show Full IntroductionHide Full Introduction