February 8, 2023

Dr. Arefa Cassoobhoy’s Morning Report.

Hello i’m dr. rf a casa voy a practicing internist and a medical editor for medscape and webmd in this week’s brief on recent medical news and findings we first look at penicillin allergies while about ten percent of the u.s. population reports a penicillin allergy a recent study in the inpatient setting found that only about one in 10 of those labeled penicillin

Allergic were actually allergic and this incorrect label in the emr is dangerous it’s associated with higher rates of hospitalizations and c diff mrs a and vre in the same study thirty-four percent of the patients on antibiotics were switched by their medical team to a more narrow spectrum penicillin or cephalosporin once their penicillin allergy label was

Removed and a recent survey of clinicians found widespread misunderstanding about penicillin allergies a sizeable number of respondents forty-two percent didn’t know a penicillin allergy can resolve over time and over eighty percent of clinicians never or rarely consulted an allergist or immunologists to confirm a reported penicillin allergy so if the emr says

That your patient is allergic to penicillin consider a deeper dive to determine whether the allergy is real it might avoid unnecessary broad-spectrum antibiotic use in their future next clinicians are being urged to reevaluate their use of levothyroxine in patients with presumed hypothyroidism there’s evidence that the drug is being over prescribed in fact it’s

The most prescribed drug in the united states and prescriptions have risen significantly in recent years yet an editorial from mayo clinic authors explains that there’s been no real increase in the incidence of hypothyroidism they blame the rise on earlier recommendations to treat subclinical increases in tsh levels even in the absence of symptoms they suggest

That prescribing levothyroxine to treat subclinical hypothyroidism should be considered on a patient by patient basis and then only after at least two elevated tsh levels measured three to six months patients with nonspecific symptoms and normal thyroid function tests do not benefit from therapy and last the us preventive services task force has finalized its

Guidelines for prescribing statins to help prevent cardiovascular disease the key points are low to moderate dose statins should be considered for adults aged 40 to 75 years who don’t have a history of cardiovascular disease but who have one or more risk factors such as dyslipidemia diabetes hypertension or smoking also consider statins for those who have a ten

Percent or higher risk of a heart attack or stroke based on their 10 year cardiovascular risk equations by the acc and aaa even some of your patients with a seven and a half to ten percent risk for an event in the next 10 years may benefit the task force also concludes that there’s not enough evidence to recommend starting statins in adults 76 years and older it

Should also be noted that these guidelines are not for patients who are extremely high risk such as those with familial hypercholesterolemia or those with ldl levels over 190 you’ll find links to each of the stories we’ve included in today’s news brief and the transcript listed below for medscape and webmd i’m dr. rf acaso boy

Transcribed from video
Morning Report: Penicillin Allergy, Levothyroxine, Statins By Medscape