geoffrey modest medical blogs

  It is generally problematic finding studies comparing newer antibiotics to older antibiotics (or   studies including  pretty much any other types of  older  medications), given that studies are largely paid for by drug companies, and it could turn out that the old medications are as good as , or perhaps better than,  the new ones the drug companies are trying to promote. An analysis, based on older studies, found that doxycycline seems to be as efficacious as macrolides or fluoroquinolones in treating mild - to - moderate community acquired pneumonia (see   pneumonia CAP doxycycline helps CID2023  in dropbox, or doi.org/10.1093/cid/ciac615)    Details :  -- a systematic review/meta-analysis of 6 randomized controlled trials with 834 patients performed between 1984 and 2004 that compared doxycycline to  3  macrolides (roxithromycin, spiramycin, and erythromycin) and  3  fluoroquinolones (ofloxacillin, fleroxacin...

  One concern with many clinical studies is that their focus is too focused: eg, does this antibiotic cover a certain infection, and is it better than other antibiotics? However, there are broader concerns in general for drugs. Do they create the basis for other problems, perhaps even worse than the initial condition? A recent VA study found that doxycycline resulted in significantly fewer cases of Clostridioides difficile infection (AKA, Clostridium dificile of old, or just CDI) vs azithromycin: see  cdiff doxy better than azithro AmJInfControl2023  in dropbox, or     https://doi.org/10.1016/j.ajic.2023.09.007   Details : -- 156,107 hospitalized patients in the VA system were diagnosed with community - acquired pneumonia  (CAP)  in the   large  VA  database,  for this retrospective study of patients  f ro m 2009-2022         -- 87%  (135,703 patients)  received azithromyci...