Journal of Urgent Care Medicine

Antibiotics Aren’t The Only Drugs That Increase Risk of C. Diff

Researchers found that antibiotics and other commonly prescribed medications substantially increase the risk of Clostridioides difficile infection, and their analysis shows that more drugs impact the gut microbiome than previously believed, as published in Gut. Recent antibiotic exposure (within 30 days) carried the highest risk. Some agents (eg, nitroimidazoles and intestinal anti-infectives) had particularly high odds ratios (OR), likely reflecting treatment-related bias, the authors say. Lipid-lowering agents (aOR 0.8, 95% CI 0.8–0.8) and aspirin (aOR …

Does Your Patient Really Have Penicillin Allergy? Probably Not.

A large international study found that direct oral challenge (DOC) can be a safe and effective strategy for identifying patients who have a true penicillin allergy. Researchers evaluated hospitalized adults who self-reported a penicillin allergy—a label that historically is attached to about 10% of patients, according to the study presented in Clinical Infectious Diseases. Among the 5,121 patients assessed, 30.7% underwent DOC; of these, 95.5% (95% confidence interval, 94.3%–96.5%) were safely “delabeled,” after assessing and …

Current Penicillin Allergy Data Paints Incomplete Picture

A meta-analysis found that the global prevalence of reported penicillin allergy is 9.4% (ranging from 5-15%), as published in the Journal of Infection, however, much of the data could be skewed because it comes from high-income countries. Researchers analyzed 174 studies from 28 countries. Of those, 72% of the studies were conducted in the United States (95 studies), United Kingdom (18), and Australia (18). Even so, previous research has shown that 95% of people identified …

Dramatic Rise in Syphilis Cases Contribute to Penicillin Shortage

Syphilis rates increased by nearly 80% between 2018 and 2022, and what’s making matters worse is the ongoing shortage of injectable penicillin, the go-to treatment for patients with syphilis. Public health agencies now are recommending providers ration the drug, according to Kaiser Health News. Pregnant patients should be prioritized first because penicillin is considered the safest treatment for the population. Doxycycline would be an appropriate drug for syphilis cases, but it’s discouraged for pregnant moms …

Conquering the Fear of Penicillin Allergy: The Boogeyman of Urgent Care

I had time to see one more patient as my shift was winding down. “Wound check. That should be a quick one,” I said to myself. Famous last words. I soon learned that the young woman with the dog bite on her hand was returning for her fourth visit in as many days for the same issue. She sat fidgeting on the exam table and was visibly irritated when I walked in the room. “It’s …

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