Tag Archive for: Infectious Disease

The Tamiflu Debacle

24 Oct
October 24, 2018

Background:  Oseltamivir (Tamiflu), a neuraminidase inhibitor, was approved by the FDA in 1999.  The majority of the evidence supporting the use of the medication came from trials funded by Roche, the maker of the drug. Safety issues with the drug began sprouting up in 2009, due to case reports in Japan of neuropsychiatric events and these events eventually led to a label warning. The Cochrane collaboration published analyses of the available data in 1999, 2003, and 2006, supporting the use of the drug. However, in 2009, the  Cochrane collaboration began to question Roche about the completeness of the data they were using, which was data from another meta-analysis with 10 RCTs.  Only 2 of those RCTs (Nicholson 2000 and Treanor 2000) were published in peer-reviewed journals.  The other 8 RCTs were presented as proceedings of congress or abstracts in meetings.  Cochrane decided to undertake a complete analysis of full clinical trial data, but had difficulties accessing the data until 2013.  This post will serve as a review of the evidence for and against the use of Oseltamivir (Tamiflu) after the full clinical trial data was finally released. Read more →

Do Patients with Strep Throat Need to Be Treated with Antibiotics?

05 Jan
January 5, 2015

Background: Streptococcal pharyngitis is a common presentation to primary care and Emergency Department physicians. Every year, 10 million patients in the United States are treated with antibiotics for pharyngitis. However, less than 10% of these patients actually have strep pharyngitis (Barnett 2013). Prescribing of antibiotics for these patients centers on three arguments:

  1. Antibiotics reduce symptomology
  2. Antibiotics reduce the rate of suppurative complications
  3. Antibiotics reduce the rate of non-suppurative complications (primarily Rheumatic Heart Disease).

So, do patients with strep throat need to be treated with antibiotics?

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