ITEMS IN AFP WITH KEYWORD:
Oral antibiotics started within seven days of surgery for patients with a serious bone or joint infection are as safe and effective as six weeks of IV antibiotics.
The findings are completely unexpected. Although recent studies by this group and other groups of researchers have failed to find a cardiovascular benefit, likely because of better control of other cardiovascular risk factors, this study found increased all-cause mortality, primarily due to increased cancer-related mortality.
Polypharmacy, commonly defined as the use of at least five medications, can have negative consequences for both the patient and health care system. Physicians should identify and prioritize medications to discontinue and discuss potential deprescribing with patients. A specific follow-up plan should be developed, including reviewing the patient’s medication list at every visit.
Compared with monotherapy, the combination of an ACE inhibitor and an ARB has not been shown to improve cardiovascular or overall mortality in patients with symptomatic heart failure. The combination is associated with an increased number of adverse drug effects.
Jun 15, 2019 Issue
H. pylori Screening Before Initiation of Long-term NSAIDs [FPIN's Clinical Inquiries]
Physicians should perform laboratory screening for and eradicate H. pylori before initiating long-term NSAID therapy in NSAID-naive patients to reduce the risk of peptic ulcer disease.
In this study, after five years of treatment, patients at a moderate risk of heart disease who took low-dose aspirin did not show a decrease in coronary events and all-cause mortality and had slightly more gastrointestinal bleeding.
In this retrospective study, statin treatment in patients 75 years or older without preexisting CVD did not change the likelihood of developing CVD or reduce any-cause mortality. However, patients 75 to 84 years of age with diabetes mellitus benefitted from treatment. These results support the results from the ALLHAT study.
Feb 15, 2019 Issue
Metformin for Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis [FPIN's Clinical Inquiries]
Metformin does not seem to be an effective treatment for nonalcoholic steatohepatitis. There are no studies evaluating whether metformin improves long-term patient-oriented outcomes such as progression from NAFLD to nonalcoholic steatohepatitis, cirrhosis, hepatocellular carcinoma, or death from liver failure.
Combination oral contraceptive pills (OCPs) are an excellent treatment option for women desiring medical therapy for hirsutism. Based on this meta-analysis, an accompanying practice guideline recommends adding an antiandrogen, such as finasteride (Propecia), if there is an inadequate response within six months.
Jan 1, 2019 Issue
Deprescribing Benzodiazepine Receptor Agonists for Insomnia in Adults [Practice Guidelines]
A multidisciplinary group of clinicians as part of the Deprescribing Guidelines in the Elderly project has developed evidence-based guidelines focused on deprescribing long-term Benzodiazepine receptor agonists (BZRAs) in patients taking them for insomnia, with the goal of helping physicians and patients make appropriate decisions about BZRA use.