Entries for September 2007

At first, two items that recently crossed my desk, separated by a couple of weeks, didn't seem to have anything in common except children—one was about antibiotics, the other about CT scans, both in a pediatric setting. But then I recognized their unintentional common theme: the consequences of overuse. The antibiotic item was in the September issue of the Journal of Family Practice. It described a study that showed a strong tie between antibiotics given to infants in their first year and the possibility that they would be diagnosed with asthma by age 7. The more antibiotics the babies got, the greater their chance of asthma down the road.

What do terms like safety and quality mean for transplant patients? Is it making sure everything about the surgery is done right, there are no complications, and the new organ isn't rejected by the body, or is there more to it? My trade tends to push me to think mostly about measurable and definable consequences like deaths, infections, and side effects. I've done transplant stories, and I know about things like having to take drugs forever after surgery to keep the body from rejecting the "foreign" organ.

Millions of Americans suffer from polypharmacy, booms the TV. Are you among them? That'd stop you cold on the way to the kitchen during a commercial break, wouldn't it? Polypharmacy means taking a large number of medications, which indeed millions of Americans do. More than 20 million people take six or more prescription and nonprescription drugs; more than 12 million take eight or more.

Those with any interest in the safety of prescription drugs—presumably that would be everyone—should take the time to read an angry editorial by Sheila Weiss Smith in the just published issue of the New England Journal of Medicine. It's available online for free, and the title says it all: "Sidelining Safety—The FDA's Inadequate Response to the IOM."

Here's a patient in intensive care. She is short of breath and feverish, shivering but hot to the touch—likely symptoms of infection. The lab needs to culture her blood to find out, and if she is infected, doctors will base the choice and amount of antibiotic on the type of bug and the extent to which it has multiplied in her bloodstream. So blood is drawn for culturing, as it is hundreds of times a day in large hospitals. Her treatment may be difficult, even touch and go if the infection is dug in, but at least it will start with this routine step.