Annals of Internal Medicine tip sheet for May 17, 2005

1. Antibiotic Successfully Prevents Travelers' Diarrhea, Study Finds

A study of 210 adults traveling in Mexico, randomly assigned to take an antibiotic drug, rifaximin or a placebo, found that those who took the drug had less mild diarrhea (14.7 percent) than those who received the placebo (53.7 percent) (Article, p. 805). Rifizimin has recently been approved in the United States for treatment of diarrhea.

An editorial writer gives four reasons why the drug should not be prescribed as diarrhea prevention for all 50 million U. S. travelers (Editorial, p. 861). The drug can be a good alternative for selected patients, the writer says, but "rapid and judicious treatment of diarrhea, not antibiotic prophylaxis, is the best recommendation for most travelers."

2. Guidelines Now Recommend Against HT for Women with Hysterectomy

Updated recommendations from the U.S. Preventive Services Task Force now recommend against routine use of estrogen alone to prevent chronic disease in postmenopausal women who have undergone hysterectomy (Guidelines, p. 855). The 2002 recommendations found insufficient evidence to recommend for or against routine use of estrogen alone to prevent chronic conditions in such women.

The new guidelines for postmenopausal women recommend against routine use of combined estrogen and progestin for the sole use of preventing chronic conditions.

3. Slightly Elevated Blood Sugar Levels Not Associated with New Heart Attacks, Study Finds

An analysis of data on 2,763 postmenopausal women with established coronary heart disease finds that women with slightly elevated blood sugar levels (impaired fasting glucose levels of 5.6 to 6.9 mmol/L) do not have increased risk for CHD (Article, p. 813).

4. Study of Five Strategies to Treat HBV Identifies Two Strategies Cost-Effective, Depending on Health Resources (Article, p. 821; Editorial, p. 863).


Contact: Susan Anderson
American College of Physicians

Page: 1

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