News in brief - Sept. 1, 2008

Drug interaction warning for some statin users

The Food and Drug Administration reissued a warning Aug. 8 about the risk for rhabdomyolysis in patients who take amiodarone with higher doses of simvastatin. The risk increases with doses of simvastatin that exceed 20 mg each day.

The agency first warned of this danger in 2002 but said it continues to receive reports of the muscle injury in patients treated concurrently with the two medications.

Although all statins increase the risk for rhabdomyolysis, the risk is considered greater when simvastatin is administered with amiodarone, a drug used to treat abnormal heart rhythms. The FDA and the manufacturer of amiodarone currently are revising prescribing information to warn of the risk.

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Study examines HIV resistance

A Baltimore woman's strong immune system apparently has thwarted the progress of an HIV infection to AIDS, according to researchers at Johns Hopkins University School of Medicine.

"Our findings offer hope to vaccine researchers because they reveal that the immune system's primary offense, known as CD8 killer T-cells, can effectively halt disease progression by a pathogenic form of HIV," said Joel Blankson, MD, PhD, an assistant professor in Johns Hopkins' Division of Infectious Diseases.

He and his colleagues uncovered the evidence in blood and genetic studies of a monogamous Baltimore couple in which both husband and wife were infected with the same strain of HIV. The husband, an IV drug user, has been taking a potent drug cocktail to keep his disease in check, but his wife has not needed any treatment and, a decade after being infected, remains symptom-free with a low viral count.

The study is in the August Journal of Virology.

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Antibiotics linked to thousands of serious adverse drug reactions

Approximately 142,505 emergency department visits each year can be linked to bad reactions to antibiotics, according to a study in the Sept. 15 Clinical Infectious Diseases.

Researchers with the Centers for Disease Control and Prevention analyzed data from the National Electronic Injury Surveillance System -- Cooperative Adverse Drug Event Surveillance Project, the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. Antibiotics were implicated in 19% of all emergency department visits for drug-related problems with the majority being allergic reactions. Sulfonamides had the highest rate of moderate to severe allergic reactions, and these drugs, along with fluoroquinolones, were linked to a greater rate of neurologic and psychiatric disturbances than other classes of antibiotics.

The authors said this information, along with that about emerging resistance, could be used to promote judicious prescription of these drugs.

"Antibiotics can have serious side effects and should only be taken when necessary," said Daniel Budnitz, MD, senior author and a CDC epidemiologist.

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Stress, anxiety make allergies worse

Patients with allergic rhinitis are at increased risk of more severe symptoms if they also are experiencing stress and anxiety, according to data presented at the American Psychological Assn. in Boston last month.

Researchers performed skin prick tests on 28 participants with this condition and assessed their baseline anxiety levels. They also subjected them to the Trier Social Stress Test, which requires them to give a speech and solve math problems in front of an audience. Anxiety and stressful activities increased the size of the wheals produced by the skin prick test.

"The results of these studies should alert practitioners and patients alike to the adverse effects of stress on allergic reactions in the nose, chest, skin and other organs," said Gailen Marshall Jr., MD, PhD, one of the authors and professor of medicine and pediatrics at the University of Mississippi in Jackson.

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