News in brief - Dec. 11, 2006

Flu drug linked to delirium, self-injury in children - Antibiotics not recommended for acute bronchitis - FDA OKs silicone breast implants - Gene sequencing centers funded - Falls become a leading killer of seniors

Flu drug linked to delirium, self-injury in children

In response to reports of adverse events associated with the use of oseltamivir in Japan, the Food and Drug Administration and the drug's manufacturer, Roche Laboratories, are adding warnings to the information accompanying this medication.

The revised label will advise consumers of a possible increased risk of delirium and self-injury among children. Causation has not been proven, but the FDA is calling on physicians to be on the lookout for any unusual behavior among pediatric patients who use this drug.

Sales of oseltamivir (Tamiflu) have increased dramatically over the past few years in response to fears of avian influenza. A study by the Centers for Disease Control and Prevention and Medco Health Solutions, which was presented at the Infectious Diseases Society of America meeting in October, found that prescriptions for it had increased more than 300% from the fall of 2004 to the fall of 2005.

The CDC and the American Medical Association recommend against stockpiling the drug because this action can lead to misuse that in turn can lead to the virus developing resistance.

Antibiotics not recommended for acute bronchitis

Acute bronchitis patients may be prescribed short-acting beta-2 agonists for relief of wheezing and offered brief courses of codeine, hydrocodone or inhaled corticosteroids. Antibiotics, however, should not be used, because most cases of this respiratory ailment are caused by viruses, according to a review published in the Nov. 16 New England Journal of Medicine.

"There is a long history of patients receiving antibiotics for acute bronchitis, and they have come to expect ... a prescription for treatment," said Richard P. Wenzel, MD, lead author and chair of the Dept. of Internal Medicine at Virginia Commonwealth University School of Medicine. "Physicians can help patients by not prescribing them antibiotics for acute bronchitis -- saving them from potential side effects and unnecessary costs."

The authors also found that chest radiography was unnecessary unless there were physical signs of pneumonia. Rapid testing to determine the cause also was not needed except during community-wide influenza outbreaks.

FDA OKs silicone breast implants

After a contentious history in which their safety was vigorously debated, silicone breast implants regained the nod of the Food and Drug Administration. They were approved Nov. 17 for use in breast reconstruction in women of all ages and breast augmentation in women 22 and older.

The FDA is requiring that the companies conduct a large post-approval study that follows about 40,000 women for 10 years after their receive the implants.

The implants are not lifetime devices, and women likely will need at least one additional surgery. Women also will need regular MRI screenings to determine if the implants rupture.

The first screening should be three years after the implant and then every two years thereafter. In the event of a rupture, the device should be removed, the FDA noted.

The approval was opposed by the Washington, D.C.-based health care watchdog group, Public Citizen. The group's director, Sidney Wolfe, MD, called the implants "the most defective medical device ever approved by the FDA."

Gene sequencing centers funded

Three sequencing centers recently received federal funding to pursue the genomic basis of disease, the National Human Genome Research Institute announced Nov. 20.

The centers will direct a significant part of their effort to the Cancer Genome Atlas Pilot Project, which is exploring the feasibility of mounting a large-scale effort to identify important genomic changes involved in cancer.

The intended result of the project is better strategies for the diagnosis, treatment and prevention of diseases, said Francis S. Collins, MD, PhD, institute director.

The centers selected are at the Massachusetts Institute of Technology and Harvard University; Washington University School of Medicine in St. Louis; and Baylor College of Medicine in Houston.

Falls become a leading killer of seniors

The rate of death associated with falls for those older than 65 has increased and is now the leading cause of injury-related death for this age group, says a paper in the Nov. 17 Morbidity and Mortality Weekly Report.

Rates increased by more than 45% for men from 1993 to 2003 and grew by nearly 60% for women. In 2003, 13,700 seniors died as a result of injuries received from a fall, and 1.8 million were hurt severely enough to require emergency department treatment.

Public health officials are calling on physicians to review medications to reduce the chance that a drug interaction could increase the risk of falling. Seniors should also exercise regularly, have their eyes checked annually and eliminate hazards in the home.