HEALTH

Study: Antibiotic use may disrupt gut flora

BY Michael Johnsen

ANN ARBOR, Mich. Patients on a course of antibiotics may have disrupted gut flora for weeks after stopping the medication, according to a report in the June issue of Infection and Immunity.

It’s common knowledge that a protective array of bacteria can be found in our intestinal tracts. Antibiotics at least temporarily disturb that normal balance. But it’s unclear which antibiotics are the most disruptive, and if the full array of “good bacteria” return promptly or remain altered for some time.

In studies in mice, University of Michigan scientists last week determined for the first time that two different types of antibiotics can cause moderate to wide-ranging changes in the ranks of these helpful guardians in the gut. In the case of one of the antibiotics, the armada of “good bacteria” did not recover its former diversity even many weeks after a course of antibiotics was over.

The findings eventually could lead to better choices of antibiotics to minimize side effects of diarrhea, especially in vulnerable patients. They also could aid in understanding and treating inflammatory bowel disease, which affects an estimated 500,000 to 1 million people, and Clostridium difficile, a growing and serious infection problem for hospitals.

The study results suggested that unless medical research discovers how to protect or revitalize the gut microbial community, “we may be doing long-term damage,” suggested Vincent Young, assistant professor in the departments of internal medicine and microbiology and immunology at the U-M Medical School, and senior author of the study.

Mice, which normally develop a diverse set of microbes after being born without one, were then given either cefoperazone, a broad-spectrum cephalosporin antibiotic, or a combination of three antibiotics (amoxicillin, bismuth and metronidazole). The scientists then observed what changes in the gut microbiota occurred immediately after the antibiotics were stopped or six weeks following the end of treatment.

“Both antibiotic treatments caused significant changes in the gut microbial community. However, in the mice given cefoperazone, there was no recovery of normal diversity. In other mice given the amoxicillin-containing combination, the microbiota largely recovered, but not completely,” Young said.

Although cefaperazone is not commonly used in the United States, such related drugs as cefoxitin are, Young said. The study findings suggested that it is very important to use antibiotics only when indicated, especially in people with health problems that might already compromise their gut microbe health. Multiple rounds of antibiotics also may deserve concern.

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CDC: H1N1 surges on through the spring, possibly summer

BY Michael Johnsen

ATLANTA The novel H1N1 virus still is proliferating, even this late into the spring, the Centers for Disease Control and Prevention reported Thursday during a press conference.

“As the summer is approaching, influenza season has normally ended by now. However, the novel H1N1 influenza transmission continues in the United States,” said Daniel Jernigan, deputy director of the influenza division at the CDC. “There are two areas of the country that continue to see increased numbers of patients in the clinic with influenza-like illness, [and] both of those are in the northeast part of the United States.”

Although, overall, there continues to be influenza activity reported in 17 states.

“The United States will likely continue to see influenza activity through the summer, and at this point, we’re anticipating that we will see the novel H1N1 continue with activity probably all the way into our flu season in the fall and winter,” Jernigan said. “There is a potential for this fall that we might have multiple sub-types circulating,” he added, especially as the novel virus circulates through a typical flu season across the southern hemisphere. “In the past with pandemic strains, [there] has been a replacement [virus],” he said, such as the pandemics in 1918, 1957 and 1968. “But right now, we don’t have enough information to say that there is a replacement occurring. And at this point, we are expecting — at least planning — that there will be multiple sub-types that are circulating at the same time this fall.”

As of Friday, the CDC reported 21,449 confirmed cases throughout the states and United States territories, up some 20.2% from the number of confirmed cases reported last week, including 87 deaths. New York leads the nation with the number of deaths at 24, followed by Texas with 10.

“There are some surveys that indicate that the amount of disease in the areas that are having activity with H1N1 is perhaps around 7% of the population reporting symptoms due to influenza-like illness,” Jernigan reported, so the number of confirmed cases may still be significantly under-representative of the actual number of patients who have contracted the novel H1N1 virus. “The virus continues to impact mostly younger people. So far it is not causing significant illness and death in the elderly like we would see with seasonal influenza. And the symptoms that are being reported are consistent with influenza, [those] being predominantly fever, cough, some shortness of breath, fatigue and chills,” Jernigan said, as well as some vomiting and diarrhea.

In addition, some 81 healthcare professionals also have tested positive for the novel H1N1 virus, so far. The CDC successfully tracked 26 of those professionals prior to May 13, and determined that roughly half of them contracted the virus at their workplace.

“[One] point that’s made in this report is related to the infection control measures that are used to prevent exposure of healthcare personnel to influenza,” commented Mike Bell, associate director for infection control at the CDC. “Probably the single most important thing is that infectious patients be identified at the front door. Whether these patients are coming in through the emergency department or the ambulatory care clinic, identifying them up front is essential so healthcare personnel know that they should be doing the things that we recommend; that consistent application of precautions is important to make sure that there isn’t occupational exposure.”

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Select Rite Aid stores to host Diabetes Solutions Days

BY Michael Johnsen

CAMP HILL, Pa. Select Rite Aid stores nationwide will host Diabetes Solutions Days on June 23 and 25, the chain announced Thursday. Consumers attending the events will be provided with diabetes-related health screenings and self-management solutions. The events include blood pressure screenings, personal pharmacist consultations and glucose meter selection and training. There also will be product coupons and samples of the latest products in at-home diabetes care, and visitors can enter a raffle at each location for a $50 Rite Aid gift card.

The free events and store locations are listed online based by zip code at www.riteaid.com; events run from 2 p.m. to 6 p.m., do not require an appointment and are part of Rite Aid’s year-round focus helping diabetes patients take the best care of themselves, the chain stated.

“The key to effective diabetes management is to understand the condition’s symptoms and treatments,” stated Robert Thompson, Rite Aid SVP pharmacy. “On Diabetes Solutions Day, patients can consult with trained Rite Aid pharmacists on their diabetes symptoms and treatment regimens, as well as sample the latest techniques in at-home monitoring.”

A free 16-page Diabetes Guide, developed with the American Diabetes Association, will be available in all Rite Aid stores, and identifies the risk factors for pre-diabetes and diabetes. It includes information on weight management and diabetes-friendly recipes. The guide also provides advice and safe treatment options on such health conditions as gum disease, dry eyes and wound and foot care, all of which can be especially harmful to people with diabetes if left untreated.

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