Monday, June 26, 2006

Vaccines, antibiotics, and atopy.

Vaccines, antibiotics, and atopy.

2006 Jun 22

Mullooly JP, Schuler R, Barrett M, Maher JE.

Center for Health Research, Kaiser Permanente Northwest, USA.


Early exposure to vaccines and antibiotics may increase the risk of developing atopy by protecting against infectious agents and reducing duration and severity of infections (the hygiene hypothesis). It may also shift the developing immune system towards a more allergic response. We assess possible associations in young allergy clinic patients.


We conducted a case-control study of 6- to 16-year-old new allergy clinic patients who were skin tested for inhalant allergens during 1987-2001 and enrolled in KPNW since birth (n = 1074). Atopic cases had positive tests for at least one inhalant allergen. Non-atopic controls had negative tests for all inhalant allergens. Using logistic regression analysis, we estimated atopy odds ratios for vaccine and antibiotic exposure variables and associations between vaccine and antibiotic exposures during the first 2 years of life and subsequent new allergy diagnoses.


Atopy was not significantly associated with numbers of vaccine and antigen doses, or number of different antigens during the first 2 years of life. Number of antibiotic prescriptions was negatively associated with atopy risk. Neither exposure was significantly associated with risk of new allergy diagnoses in atopic children.


Atopy development appears to be unrelated to early vaccine exposure. Frequency of antibiotic prescriptions during early life, a proxy for infection frequency, appears to protect against allergic sensitization. Neither vaccines nor antibiotics appear to induce subsequent allergic reactions in atopic children. Copyright (c) 2006 John Wiley & Sons Ltd.

PMID: 16794993 [
PubMed - as supplied by publisher]

Saturday, June 17, 2006


Spectinomycin injection

Active Ingredients: Spectinomycin
Representative Names: Trobicin

What is spectinomycin injection?

SPECTINOMYCIN (Trobicin®) is an antibiotic. It treats and cures gonorrhea (a type of sexually transmitted or venereal disease). Generic spectinomycin is not available

What should my health care professional know before I receive spectinomycin?

They need to know if you have any of these conditions:

syphilis - you need to be tested for syphilis before treatment with spectinomycin is started
an unusual or allergic reaction to spectinomycin or other antibiotics, other medicines, foods, dyes or preservatives
pregnant or trying to get pregnant

How should I use this medicine?

Spectinomycin is for injection into a muscle

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed

What if I miss a dose?

Spectinomycin is usually given as a single dose. If you do need more than one dose it is important not to miss your appointment. If you miss a dose, get it as soon as you can

What drug(s) may interact with spectinomycin?

There are no interactions known.

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking spectinomycin?

Tell your prescriber or health care professional if your symptoms do not improve in a few days
Anyone you have had sex with needs treatment for gonorrhea. Use a condom to stop reinfection of either you or your sexual partner

You may get dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how spectinomycin affects you

What side effects may I notice from receiving spectinomycin?

Side effects that you should report to your prescriber or health care professional as soon as possible:

fever or chills
skin rash, itching
Minor side effects include:
irritation or pain at the injection site
nausea, vomiting
reduced urine output

Where can I keep my medicine?

Keep out of the reach of children
Store the dry powder at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Do not freeze the diluent. After dissolving the powder, keep injection solution at room temperature between 15 and 30 degrees C (59 and 86 degrees F), and use within 24 hours. Throw away any unused injection solution

St. John's Health


Discontinuation of Spectinomycin

JAMA. 2006;295:2245.

MMWR. 2006;55:370

In January 2006, CDC learned that Pfizer, Inc. (New York, New York) had discontinued U.S. distribution of spectinomycin (Trobicin®) in November 2005; remaining inventory will expire in May 2006. No other pharmaceutical company manufactures or sells spectinomycin in the United States. Pfizer is continuing to distribute spectinomycin outside the United States for the international market. CDC and the Food and Drug Administration are working with Pfizer to make spectinomycin available again in the United States and will update this information as soon as possible.

Historically, spectinomycin has been used to treat persons infected with Neisseria gonorrhoeae who cannot receive one of the two first-line treatments (i.e., fluoroquinolones or third-generation cephalosporins) currently recommended for treatment of uncomplicated gonococcal infection.1 Relatively few indications exist for which spectinomycin is the preferred treatment option for N. gonorrhoeae; these include (1) pregnant women with penicillin or cephalosporin allergy (fluoroquinolones are contraindicated during pregnancy), (2) persons with penicillin or cephalosporin allergies who reside in areas with a high prevalence of quinolone-resistant N. gonorrhoeae,1-2 and (3) men with penicillin or cephalosporin allergies who have sex with men.3

No acceptable alternatives to spectinomycin therapy are currently available. Persons with penicillin or cephalosporin allergies who cannot receive fluoroquinolones can be desensitized to cephalosporins before treatment.4 Although 2 grams of azithromycin orally in a single dose is effective against uncomplicated gonococcal infection, no data are available to assess the safety and efficacy of this regimen in pregnant women. Moreover, concerns exist regarding the emergence of antimicrobial resistance if azithromycin is used widely in the treatment of N. gonorrhoeae.


1. CDC. Sexually transmitted diseases treatment guidelines 2002. MMWR. 2002;51(No. RR-6):1-80. PUBMED
2. CDC. Increases in fluoroquinolone-resistant Neisseria gonorrhoeae—Hawaii and California, 2001. MMWR. 2002;51:1041-1044. PUBMED
3. CDC. Increases in fluoroquinolone-resistant Neisseria gonorrhoeae among men who have sex with men—United States, 2003, and revised recommendations for gonorrhea treatment, 2004. MMWR. 2004;53:335-338. PUBMED
4. Park MA, Li JTC. Diagnosis and management of penicillin allergy. Mayo Clin Proc. 2005;80:405-410. ISI PUBMED

Journal of the American Medical Association

Sunday, June 11, 2006


Remember, this was the week with the date 06/06/06?? With only an hours notice GoDaddy, our fee-paid host of LymphedemaPeople abruptly decided our forums were gobbling up too much space, so they shut them down.

As a result, we had to put in completely new ones.

But, it takes more then lymphedema, lymphoma or GoDaddy to slow usdown and...

THE NEW FORUMS ARE UP AND RUNNING!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Our new forums represent a significant upgrade with many newfeatures, upgraded security and abilities. There are a number ofnew forums that we have added (including one for cancer) and many familiar ones like our children's forum, advocacy and more.

If you were a member of our old forums, we would love to have youcontinue with our family.

Please go ahead and reregister. We were hoping to automatically transfer membership, but that may be more problematic then werealized.

If you have never joined us there, come, share the excitement as wemove forward with the most comprehensive website on the internet forlymphedema and lymphatic conditions.

I will be working feverishly this weekend to see that all thearticles of the old forums are in place again.

In the meantime look forward to seeing everyone there!!!

Lymphedema People

My Best to All!!!!


Saturday, June 03, 2006

Antibiotic treatment of wheezing in children with asthma: what is the practice?

Pediatrics. 2006 Jun;117(6):e1104-10.

Kozyrskyj AL, Dahl ME, Ungar WJ, Becker AB, Law BJ.Faculty of Pharmacy, University of Manitoba, Winnipeg, Manitoba, Canada.


Antibiotics are not recommended for the treatment of wheezing in children with asthma, but little is known about their use. This study was undertaken to evaluate trends and determinants of antibiotic use in children with wheezing during the fiscal years 1995 through 2001.


Using the population-based health care and prescription databases in Manitoba, Canada, this descriptive study examined time trends in antibiotic prescription use for wheezing episodes in a population of children with asthma. The likelihood of receiving an antibiotic prescription according to child and physician characteristics also was determined. Annual population-based rates of antibiotic prescriptions for wheezing episodes were modeled by age and antibiotic class, using general estimating equations. The odds ratio for receiving an antibiotic prescription according to child demographics and physician factors was determined from hierarchical linear modeling.


The antibiotic prescription rate for wheezing decreased by 28% from 708 prescriptions per 1000 children with asthma in 1995 to 511 prescriptions in 2001. Fifteen-fold increases in use were observed for broader spectrum macrolides in preschool children. Twenty-three percent of physician visits for wheezing resulted in an immediate antibiotic prescription, but this percentage increased to 64% for antibiotics that were received within 7 days of the episode. General practitioners prescribed antibiotics more often than did pediatricians. Physicians who were not trained in Canada or the United States were 40% more likely to prescribe antibiotics than their counterparts.


Antibiotic use for wheezing in children declined in the 1990s, but the increased use of broader spectrum macrolides has implications for antibiotic resistance. A link between antibiotic prescribing and physician specialty and location of training identifies opportunities for intervention.

PMID: 16740813 [PubMed - in process]