News in brief - May 8, 2006

Nations limit antibiotic use in food animals to curb drug resistance - Behavioral therapies may prevent relapse of anorexia nervosa - FDA awards contract to evaluate postmarketing study system - Elderly cancer survivors have reduced physical function

Nations limit antibiotic use in food animals to curb drug resistance

Australia's policy of restricting antibiotic use in food-producing animals may be linked to lower levels of drug-resistant bacteria among the nation's population, according to an article in the May 15 Clinical Infectious Diseases, now available online.

Campylobacter jejuni is a leading bacterial cause of food-borne illness in industrialized countries.

Drug resistance can make infection with this bacteria difficult to treat and can result in longer bouts of diarrhea and a higher risk of serious illness. Bacterial resistance to drugs is generally attributed to inappropriate prescribing or overuse of antibiotics.

An Australian solution to the drug-resistance problem has been to prohibit the use of certain antibiotics, fluoroquinolones, in food animals, such as poultry. Sweden and Norway have adopted similar policies regarding antimicrobials in animals and their rate of drug resistance is also lower than in countries that allow the practice.

"There are different causes that lead to bacterial antibiotic resistance, and use of antibiotics in food animals is only one of multiple causes," said lead author Leanne Unicomb, an epidemiologist with Australia National University.

The AMA and the World Health Organization have urged the prudent use of antibiotics in food animals to halt the growing resistance to common antibiotics. The U.S. Food and Drug Administration proposed last month that antivirals be prohibited in food animals because of the risk that the drugs would not be as effective in humans in the event of an outbreak of avian flu among people. The ban would take effect in June. But the agency has not yet forbidden the use of antibiotics among food animals.

Behavioral therapies may prevent relapse of anorexia nervosa

No available medications can effectively treat patients with anorexia nervosa, but a few behavioral therapies could help prevent at least a relapse of the serious eating disorder, according to the Agency for Healthcare Research and Quality after reviewing the current literature.

The agency's review also found that several medications and behavioral therapies can help patients with bulimia nervosa and binge eating disorder.

Cognitive behavioral therapy that helped patients develop thinking patterns that could counteract their unhealthy eating behavior was found to help prevent relapse in adult anorexic patients after their weight had been restored to a normal level. There was not enough evidence to determine whether the therapy worked during the acute phase of the illness.

The researchers also concluded that family therapy does not appear to work with adults who have longstanding anorexia nervosa. But one study found that family therapy did seem to work better for younger patients.

FDA awards contract to evaluate postmarketing study system

The Food and Drug Administration has awarded a contract to Booz Allen Hamilton, a global strategy and technology consulting firm, to evaluate the process for devising and completing postmarketing study commitments, according to a statement issued by the agency last month.

Postmarketing study commitments are often garnered from companies as part of the approval process for drugs and biologics. This action was taken because of the growing recognition that these studies are vital but frequently left undone.

"Even the largest and best designed premarket studies cannot reasonably answer all of the important questions that may arise about medicines," said Steven Galson, MD, director of the FDA's Center for Drug Evaluation and Research.

The FDA hopes that this review will result in a greater consistency in requirements between the agency's different centers and improvements in the overall process that will lead to more of these studies being completed in a timely manner.

The evaluation begins this month and is expected to take a year.

Elderly cancer survivors have reduced physical function

Older women who have survived cancer are less likely than counterparts who never had the disease to be capable of doing heavy housework, walking half a mile or going up and down stairs, according to a study in the April 19 Journal of the National Cancer Institute.

More than 25,000 women participating in the Iowa Women's Health Study filled out questionnaires about their functional ability. About 42% of those who had had cancer could not do heavy housework, compared with 31% who had not had this disease. Also, 26% of cancer survivors could not walk a mile, while only 19% of their healthier counterparts had this problem. In addition, 9% of cancer survivors had difficulties with stairs, while only 6% of their cancer-free counterparts had similar problems. Those were less than two years away from cancer treatment had the most problems.

The authors suggest that interventions are needed to maintain the quality of life for the growing number of elderly cancer survivors.