Research Roundup

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Debbie Rigby rounds up the latest in research news

Direct Challenges to Penicillin-Based Antibiotics in the Inpatient Setting

Direct challenge (DC) is an emerging safe and effective alternative to penicillin skin testing (PST) in patients reporting a low-risk reaction history. In this study patients with a cutaneous reaction history less than 20 years ago, a history of angioedema, or reactions involving multiple body systems underwent PST followed by a 1-time observed dose of amoxicillin. Patients with low-risk, cutaneous-only reaction histories (rash, hives, itching) more than 20 years ago were offered a 3-step direct challenge. Almost all (97.9%) patients tolerated the direct challenge. The sole patient with an immediate reaction was treated with an antihistamine alone.

Journal of Allergy and Clinical Immunology: In Practice 2020;8(7):2294-2301.


Perioperative Use of Gabapentinoids for the Management of Postoperative Acute Pain

In a meta-analysis of 281 randomized controlled trials comparing gabapentinoids with controls, no clinically meaningful difference in acute, subacute, or chronic pain was observed. There was no effect from the perioperative use on the prevention of postoperative chronic pain. The use of gabapentinoids was associated with a slightly lower risk of postoperative nausea and vomiting but with more dizziness and visual disturbance.

Anesthesiology. Published on June 26, 2020.


Warfarin and food, herbal or dietary supplement interactions

This systematic review of 149 articles revealed 78 herbs, food or dietary supplements reported to interact with warfarin. Several foods and herbs can interact with warfarin to increase the risk of bleeding, including Chinese wolfberry, chamomile tea, cannabis, cranberry, chitosan, green tea, Ginkgo biloba, ginger, spinach, St. John’s Wort, sushi and smoking tobacco. The authors concluded that patients should be counselled to continue to seek advice from their healthcare professionals when starting any new herbs, food or supplement.

British Journal of Clinical Pharmacology, first published 1 June 2020.


Association of Statin Use With All-Cause and Cardiovascular Mortality in US Veterans 75 Years and Older

In this retrospective cohort study of US veterans (mean age 81 years) without atherosclerotic cardiovascular disease at baseline, statin therapy was significantly associated with a lower risk of mortality. Statin use, compared with no statin use, was significantly associated with a lower risk of all-cause and cardiovascular mortality (hazard ratios, 0.75 and 0.80, respectively).

JAMA. 2020;324(1):68-78.


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