Debbie Rigby rounds up the latest in research news 

Alterations in fecal microbiota composition by probiotic supplementation in healthy adults

A systematic review of 7 randomised controlled trials has demonstrated a lack of evidence for an impact of probiotics on faecal microbiota composition in healthy adults. No effects were observed on the fecal microbiota composition in terms of α-diversity, richness, or evenness in any of the included studies when compared to placebo.

Genome Medicine 2016;8:52

 

Defining Optimal Length of Opioid Pain Medication Prescription After Common Surgical Procedures

Ideally, opioid prescriptions after surgery should balance adequate pain management against the duration of treatment. In practice, the optimal length of opioid prescriptions lies between the observed median prescription length and the early nadir, or 4 to 9 days for general surgery procedures, 4 to 13 days for women’s health procedures, and 6 to 15 days for musculoskeletal procedures.

JAMA Surg. Published online September 27, 2017.

 

Loperamide (Imodium): reports of serious cardiac adverse reactions with high doses of loperamide associated with abuse or misuse

Serious cardiovascular events (such as QT prolongation, torsades de pointes, and cardiac arrest), including fatalities, have been reported in association with large overdoses of loperamide. If symptoms of overdose occur, naloxone can be given as an antidote. Since the duration of action of loperamide is longer than that of naloxone (1–3 hours), repeated treatment with naloxone might be indicated; patients should be monitored closely for at least 48 hours to detect possible CNS depression.

Medicines and Healthcare products Regulatory Agency, September 2017.

 

Miconazole (Daktarin): over-the-counter oral gel contraindicated in patients taking warfarin

Bleeding events, some with fatal outcome, have been reported with use of miconazole oral gel by patients on warfarin. Patients taking warfarin should not use over-the-counter miconazole oral gel available from pharmacies.

Medicines and Healthcare products Regulatory Agency, September 2017.