Monday, March 30, 2015

Use of cephalosporins in penicillin-allergic patients

Let's start with a patient case.  A 71 year old patient arrives to the emergency room complaining of shortness of breath and sputum production that has worsened from when it started about three days ago.  She has a past medical history of diabetes mellitus type 2, myasthenia gravis, and atrial fibrillation and is taking metformin, pyridostigmine, prednisone, warfarin, and sotalol.  Her BP = 132/88, HR = 78, RR = 24, and T = 37.5 C and CXR reveals a left lower lobe infiltrate.  The diagnosis of pneumonia is made and as you begin to type orders for your standard ceftriaxone/azithromycin combination, you note that the patient has a penicillin allergy.  What is the risk of continuing this antibiotic regimen given the patient's allergy?

Sunday, March 15, 2015

Effectiveness of homeopathy for various conditions

Homeopathy is a part of complementary and alternative medicine (CAM) that is an undeniable component of the healthcare industry in the United States.  A nationwide government survey from 2007 estimated that U.S. adults spent approximately $33.9 billion out-of-pocket on CAM.  Of this, $3.1 billion was spent on homeopathic medicine (compare this to $14.8 billion spent on natural products (nonvitamins and nonminerals) and $47.6 billion which was spent on prescription medications)1.  For more of an explanation of what homeopathy is with an example, see below. 

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