Surveyed Physicians Report That Emergence of Drug-Resistant Pathogens in Pneumonia is Driving Shifts and Changes in Treatment and Prescribing Practices

BioTrends Research Group and AMR in their TreatmentTrends^®: Pneumonia (U.S.) report find that for the management of nosocomial pneumonia (NP), the most commonly cited change in treatment practices of surveyed physicians in the past five years has been adapting and responding to the increasing incidence of drug-resistant pneumonia. Such changes include evidence-based prescribing, drug-susceptibility testing, consistent de-escalation of therapy, and increased use of carbapenems, colistin, and Pfizer’s Zyvox (linezolid) and Tygacil (tigecycline). Buy Glucophage (Metformin Bp) pills online without prescription Furthermore, the prescribing of combination therapy is dominant in the management of pneumonia in the inpatient setting with approximately 80 percent of surveyed physicians indicating a preference for combination therapies for the empiric treatment of community-acquired pneumonia (CABP) and NP.

“Broad-spectrum therapies with both Gram-negative and MRSA coverage, such as Forest/AstraZeneca/Dainippon Sumitomo’s Teflaro (ceftaroline), can offer the potential of a single monotherapy for the treatment of pneumonia, especially CABP.”

“The use of combination therapy to manage pneumonia is routine as physicians seek to expand spectrum activity and target multiple pathogens (e.g., MRSA and Gram-negative pathogens) commonly associated in NP or to attack a refractory pathogen, such as Pseudomonas aeruginosa” said Associate Therapeutic Class Director of Infectious Diseases Brenda Perez-Cheeks, Ph.D. “Broad-spectrum therapies with both Gram-negative and MRSA coverage, such as Forest/AstraZeneca/Dainippon Sumitomo’s Teflaro (ceftaroline), can offer the potential of a single monotherapy for the treatment of pneumonia, especially CABP.”
Although proven efficacy in the treatment of pneumonia is an important drug attribute to surveyed physicians, the majority are comfortable with off-label prescribing for the management of NP, reporting that in vitro data demonstrating appropriate pathogen coverage and pharmacokinetic data, including tissue penetration, is sufficient to support their prescribing of drugs for the treatment of NP. In fact, nearly one-quarter of surveyed physicians indicate prescribing ceftaroline for CABP due to MRSA, and about 10 percent have used the drug for NP in the past 12 months.
Also, the potential to lower the risk of systemic toxicity and to target delivery of antibiotics directly to lung tissues are the leading reasons surveyed physicians are treating NP patients with inhaled antibiotic therapy, estimating 1 in every 12 patients are treated using this method of drug delivery.
About TreatmentTrends
TreatmentTrends: Pneumonia (U.S.), which includes research with 50 infectious diseases specialists and 51 critical care/internists physicians, analyzes the usage and uptake of antibiotics for the treatment of patients diagnosed with CABP and NP, including hospital-acquired pneumonia, healthcare-associated pneumonia, and ventilator-associated pneumonia in the hospital setting.
About BioTrends Research Group
BioTrends Research Group provides syndicated and custom primary market research to pharmaceutical manufacturers competing in clinically evolving, specialty pharmaceutical markets.
About Arlington Medical Resources
AMR  serves the market intelligence needs of the pharmaceutical and diagnostic imaging industries. Research includes clinical inpatient and hospital databases that directly link anti-infective drugs with indication/procedure, formulary and stocking status tracking studies, drug purchasing audits and diagnostic imaging procedure volume/contrast media usage audits. AMR is a Decision Resources Group company.
About Decision Resources Group
Decision Resources Group is a cohesive portfolio of companies that offers best-in-class, high-value information and insights on important sectors of the healthcare industry. Clients rely on this analysis and data to make informed decisions.

Diabetes Initiative Taps Power of Rx Pad to Drive Healthy Food Choices

-The University of Chicago Medicine and Walgreens are teaming up to launch a “Food Rx” initiative that will help people with diabetes improve their eating habits by overcoming two major hurdles when shopping for food: access and affordability. Buy Aggrenox (Asiprin - Dipyridamole) pills online without prescription

“The Food Rx program will enable patients suffering from diabetes to discover how much better their lives can be if they put good food on their plates.”

As part of the Improving Diabetes Care and Outcomes on the South Side of Chicago, a project based at the University of Chicago Medicine, diabetes patients who visit one of six South Side clinics can receive a prescription-like checklist of their doctor’s food recommendations and a coupon for $5 off $20 worth of healthy food at participating Walgreens locations. Patients also can get a $3 voucher for the weekly 61st Street Farmers Market in the Woodlawn neighborhood.
Monica Peek, MD, assistant professor of medicine and associate director of the Chicago Center for Diabetes Translation Research, said the initiative puts the power of a prescription behind a doctor’s counsel on diet.
“The factors driving the diabetes prevalence rate on the South Side are multifaceted, and addressing them requires a comprehensive, nuanced approach,” said Peek, lead on the Food Rx initiative. “Many of the patients we see have challenges accessing and preparing healthy food. Through continued education and initiatives like this one, we’re working to chip away at the obstacles and alter behaviors.”
Multiple studies have established the strong correlation of food costs and access with obesity, diabetes, hypertension and cancer rates. Many residents of the South Side do not have easy access to a nearby supermarket to purchase fresh produce and other healthy options. Instead, they opt for convenience and low-priced options by going to fast food restaurants or buying processed foods from corner stores.
The Food Rx initiative builds on the Improving Diabetes Care and Outcomes on the South Side of Chicago interventions already under way, including patient education, grocery store tours, tools for health care providers, improvements to clinic systems and relationships with community organizations such as food pantries.
Food Rx organizers say the participating clinics are natural collaborators in this effort because they already serve the target population. In addition, Walgreens’ prominence in urban communities and its commitment to provide greater access to fresh fruits and vegetables, low-fat dairy products and whole grains in many locations, make the Deerfield-based health and daily living destination another ideal ally.
“Walgreens is uniquely positioned to help improve health outcomes through the pharmacy, health and wellness services we provide and by making fresh and affordable food options available to South Side communities with limited access to healthier options,” said Denise Scarpelli, Walgreens market pharmacy director. “Each day, our pharmacists provide valuable information, advice and support in the communities we serve. Through this program, the important patient-pharmacist relationship is taken to a new level and connects people with their pharmacist in a meaningful way.”
Food Rx also is working with the 61st Street Farmers Market, which features more than two dozen vendors offering locally grown fruits and vegetables, fresh whole grain breads, dairy products and healthy homemade meals. The market was launched in 2008 by the nonprofit organization Experimental Station and a group of residents who wanted access to fresh, seasonal food.
“Through our 61st Street Farmers Market, we’re helping to rebuild the food culture on the South Side and change food consumption patterns by making fresh and healthy foods available, more affordable and more desirable to the local community,” said Connie Spreen, executive director of Experimental Station. “The Food Rx program will enable patients suffering from diabetes to discover how much better their lives can be if they put good food on their plates.”
Marshall Chin, MD, professor of medicine, director of the Chicago Center for Diabetes Translation Research and co-principal investigator of Improving Diabetes Care and Outcomes on the South Side of Chicago, points out that while the impact of food access is significant, particularly when it comes to diabetes, there are many other dynamics at play with health disparities.
“These include cultural issues, health system issues, unconscious bias, residential segregation, fewer treatment options and limited community resources,” Chin said. “Our overall project tries to address many of these elements. With the Food Rx program, we’re helping people with some of the elements they can control. Diabetes management is largely lifestyle — what you eat and what you do.”
The Food Rx organizers will continue to look for other accessible destinations for healthy foods. Researchers will review feedback, redemption rates and other data from each site to evaluate program effectiveness and make any necessary tweaks.
Peek is proud of the Food Rx collaboration, and she acknowledges that transforming cultural norms that are generations in the making will not be easy.
“We didn’t get here overnight,” she said. “But there is proven effectiveness in empowering people to make better choices, overcome social determinants and play a stronger role in their own health outcomes.”
Improving Diabetes Care and Outcomes on the South Side of Chicago is funded by the Merck Company Foundation and National Institutes of Health.

 

Metal-On-Metal Hip Replacement No Extra Cancer Risk At Seven Years

According to a study in bmj.com, the risk of developing cancer within the first seven years after receiving a metal-on-metal hip replacement is no higher than in the general population, although further long-term studies are required.

BBC Newsnight and the BMJ recently investigated potentially high levels of toxic metals from failing hip implants that could affect thousands of people worldwide in the future. The authors also investigated as to why these hip replacements were permitted, regardless of the fact that the risks have been known and documented for decades. Buy Levothroid Synthroid pills online without prescription

The investigation was commissioned by the National Joint Registry of England and Wales, which contains over one million procedures from more than 97% of orthopedic units, and executed by researchers from the Universities of Bristol and Exeter, who investigated the validity of these concerns. To evaluate the success rates of joint implant patients, the registry data and hospital statistics are linked each year.

The authors decided to compare cancer rates in patients with metal-on-metal hip replacements with patients with other types of hip implants, as well as with the general population. 40,576 registered patients in total, i.e. 14% had some kind of metal-on-metal bearing surface, whilst 21,264 patients or 7% had a stemmed metal-on-metal prosthesis and 19,312 patients or 7% had a resurfacing procedure.

The authors compared patient outcomes by using mathematical models that included the patient's age and sex, as well as three measures of the patient's general health at the time of hip surgery, i.e. the American Society of Anesthesiologists grade, which scores the patient's other serious illnesses, the number of NHS funded hospital admissions within the previous five years as well as the number of distinct diagnostic codes recorded at time of surgery.

According to the authors, a comparison between hip replacement patients with people in the general population is not really straightforward, given that hip replacement patients "tend to be healthier than others of the same gender and age group".

The outcome of the study demonstrated that the likelihood of a 60 year old man of moderate health and a metal-on-metal stemmed hip replacement will be diagnosed with cancer five years after surgery is 6.2% as compared with a likelihood of 6.7% in men with hip replacements that contain other bearing surfaces. In women, these figures were 4.0% and 4.4% for other bearing surfaces respectively.

The findings furthermore reveal that the incidence of diagnosed cancers after hip replacements is low, whilst that predicted for the age and sex of the matched general population is lower.

The authors believe that their study will assist clinicians in reassuring their patients that the "risk of cancer for hip replacement patients is relatively low" and that there is no evidence that metal-on-metal hip replacements pose a higher risk of cancer.

The authors recognize that the results only include findings for up to seven years after surgery and recommend that further long-term data analyses will be performed over the next few decades, given that this is the lead-time for some cancers to develop.