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Daptomycin: A novel lipopeptide antibiotic for the treatment of resistant gram-positive infections (PDF)

The continuing rise of resistance rates among bacteria today has led to the need for the development of new antibiotics with the ability to circumvent current resistance mechanisms. Daptomycin (Cubicin, Cubist Pharmaceuticals) is an injectable novel lipopeptide antibiotic shown to have excellent in vitro bactericidal activity against gram-positive organisms, including resistant isolates. First in the new class of lipopeptide antibiotics, daptomycin possesses a unique mechanism of action. Daptomycin was recently approved by FDA for the treatment of complicated skin and skin structure infections caused by susceptible strains of specific gram-positive microorganisms. Daptomycin may offer an alternative in the treatment of gram-positive infections, especially when resistance is suspected.

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Wyeth reports off-label use of venlafaxine associated with pediatric risks

A recent "Dear Healthcare Professional" letter issued by Wyeth outlines the potential risks associated with the company's antidepressant venlafaxine (Effexor and Effexor XR) when the drug is administered in the pediatric population. The letter, dated August 22, 2003, cites data from clinical studies in pediatric patients (aged 6­17 y) and details changes that have been made to the labeling for venlafaxine. Venlafaxine has been prescribed off-label in the pediatric population despite never being approved by FDA for use in children or adolescents.

Patient-based strategies encourage increased use of generic drugs

As patient-based strategies promote acceptance and wider use of generic drugs, managed care organizations' (MCOs's) tools now include aggressive voucher programs that go so far as to provide preprinted prescription blanks for patients to take to their doctors.

Eszopiclone: A novel cyclopyrrolone with potential benefit in both transient and chronic insomnia (PDF)

Benzodiazepines are the gold standard for the treatment of insomnia. However, because of their potential for pharmacologic dependence and withdrawal reactions upon discontinuation, they are neither recommended or FDA-approved for chronic use. The novel cyclopyrrolone eszopiclone (es zoe pik? lone) (Estorra, Sepracor) is a stereoselective isomer of the agent zopiclone, which has been available in Europe for more than a decade. Clinical trials in patients with chronic insomnia suggest the medication may help manage both transient and chronic insomnia with minimal side effects. The most commonly reported side effect with the agent is a bitter taste. The apparent efficacy and favorable side effect profile together with its potential for obtaining the first indication for the management of chronic insomnia in the United States make eszopiclone an attractive therapeutic option. If the drug is approved by FDA, a key issue for formulary decision-makers will be whether to make it openly available or through prior authorization for specific clinical situations. Eszopiclone?s pricing may ultimately determine its use by clinical psychiatrists and reimbursement by insurers.

Experience Brief: How to create a therapeutics committee that is scientifically and economically sound (PDF)

One of the primary goals in today?s medical environment is to find treatments that provide positive clinical outcomes but also satisfy pressures on healthcare professionals and hospitals to deliver care as cost effectively as possible. To attain this goal, a hospital must have a pharmacy and therapeutics committee that is both scientifically and economically sound. Based on the experience of over 25 years each of the former chairman of the pharmacy and therapeutics committee (R. Quintiliani) and the director of Drug Information Services (R. Quercia) at Hartford Hospital, a large tertiary hospital in Connecticut, this article addresses ways to accomplish this goal, with particular attention given to anti-infective agents.

Statins linked to reduced risk of cancer

Users of statins were 20% less likely to have cancer (adjusted odds ratio, 0.80; 95% CI, 0.66­0.96) in a case-control study from the Academic Medical Centre, University of Amsterdam, Netherlands, that was presented at the 39th Annual Meeting of the American Society of Clinical Oncology

Treatment for male pattern baldness delays prostate cancer

Finasteride (Propecia, Merck), an inhibitor of 5a-reductase, prevents or delays the appearance of prostate cancer by 24.8% (P<.001), according to researchers from the University of Texas Health Science Center, San Antonio, Texas.

Cardiovascular benefit of 'polypill' evaluated in BMJ

Three different drugs at half the standard dose are estimated to reduce the risk of stroke by 63% and ischemic heart disease (IHD) events by 46% for those aged 60 to 69 years, according to a study in BMJ. Another study published in the same issue recommends that those with known occlusive vascular disease and everyone aged 55 years or older take a "polypill," including the combination of blood pressure-lowering drugs, a statin, folic acid, and aspirin.

Rebetol (Ribavirin)

First combination therapy for treating hepatitis C in children

The treatment of acute severe asthma in the adult: an overview

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Asthma is a chronic inflammatory disease of the airways affecting 5%–7% of the US and European populations. It accounts for nearly 400,000 hospitalizations and 5,000 deaths per year. Acute asthma comprises those asthmatics with severe symptoms, despite attempts at appropriate control. Typically these patients will present to a local emergency department for evaluation and treatment. This review examines the pharmaceutical treatment options made available to these patients in emergency settings, including their risks, benefits, side effects and overall effectiveness. (Formulary 2003;38:537–543.)