Debbie Rigby rounds up the latest in research news
A Cochrane review has concluded that there is no clear evidence that probiotics are more effective than placebo at preventing infantile colic; however, daily crying time appeared to reduce with probiotic use compared to placebo. Probiotics containing Lactobacillus reuteri showed a reduction of 44.26 minutes in daily crying. There were no clear differences in adverse effects.
Cochrane Database of Systematic Reviews 2019, Issue 3.
This editorial by Barb Farrell and Dee Mangin describes the 5 steps to individualize deprescribing practices to each patient. Shared decision making about deprescribing can inform the conversation with patients. As a possible precursor to discontinuation, a “pause and monitor” (drug holiday) approach can be an appealing choice for patients and other prescribers, but it should be combined with a clear plan for dosage changes, monitoring and follow-up, and agreed criteria for restarting.
Am Fam Physician. 2019;99(1):7-9.
This hospital-based study describes the desire of patients and caregivers to be involved in medicine decision-making, and identify attitudinal predictors of desire to try stopping a medicine. A substantial proportion of patients and caregivers did not want to be involved medication decision-making. The three diagnostic indicators for establishing desire to try stopping a medicine are perceived necessity of the medicine, appropriateness of the number prescribed medications and a desire for dose reduction.
An unconfirmed penicillin allergy is known to confer significant risk to patients. Most patients, who are appropriate candidates for a direct oral amoxicillin challenge, to confirm current penicillin tolerance, can be safely identified by their clinical histories. Direct oral amoxicillin challenges in low-risk individuals are well accepted by patients and a safe and effective part of penicillin allergy delabeling.
Curr Allergy Asthma Rep 2019;19:27.