Combating Antibiotic Resistance

antibioticThe Federal Food and Drug Administration (FDA) states that antibiotics resistance is a growing public health concern worldwide.

According to the FDA, when a person is infected with an antibiotic-resistant bacterium, not only is treatment of that patient more difficult, but the antibiotic-resistant bacterium may spread to other people.

For many years we have relied on antibiotics to keep us healthy, sometimes to the point of insisting that we have an antibiotic even when our doctor tell us it is not warranted.

The FDA describes antibiotics as drugs used for treating infections caused by bacteria. Misuse and overuse of these drugs, however, have contributed to a phenomenon known as antibiotic resistance.

This resistance develops when potentially harmful bacteria change in a way that reduces or eliminates the effectiveness of antibiotics.

When antibiotics don’t work, the result can be:

  • longer illnesses
  • more complicated illnesses
  • more doctor visits
  • the use of stronger and more expensive drugs
  • more deaths caused by bacterial infections

Examples of the types of bacteria that have become resistant to antibiotics include the species that cause skin infections, meningitis, sexually transmitted diseases and respiratory tract infections such as pneumonia.

In cooperation with other government agencies, the Food and Drug Administration (FDA) has launched several initiatives to address antibiotic resistance.

The agency has issued drug labeling regulations, emphasizing the prudent use of antibiotics. The regulations encourage health care professionals to prescribe antibiotics only when clinically necessary, and to counsel patients about the proper use of such drugs and the importance of taking them as directed. FDA has also encouraged the development of new drugs, vaccines, and improved tests for infectious diseases.

Antibiotics Fight Bacteria, Not Viruses

Antibiotics are meant to be used against bacterial infections. For example, they are used to treat strep throat, which is caused by streptococcal bacteria, and skin infections caused by staphylococcal bacteria.

Although antibiotics kill bacteria, they are not effective against viruses. Therefore, they will not be effective against viral infections such as colds, most coughs, many types of sore throat, and influenza (flu).

Using antibiotics against viral infections

  • will not cure the infection
  • will not keep other individuals from catching the virus
  • will not help a person feel better
  • may cause unnecessary, harmful side effects
  • may contribute to the development of antibiotic-resistant bacteria

So how do you know if you have a bad cold or a bacterial infection?

Joseph Toerner, M.D., MPH, a medical officer in FDA’s Center for Drug Evaluation and Research, says that the symptoms of a cold or flu generally lessen over the course of a week. But if you have a fever and other symptoms that persist and worsen with the passage of days, you may have a bacterial infection and should consult your health care provider.

Follow Directions for Proper Use

When you are prescribed an antibiotic to treat a bacterial infection, it’s important to take the medication exactly as directed. Here are more tips to promote proper use of antibiotics.

  • Complete the full course of the drug. It’s important to take all of the medication, even if you are feeling better. If treatment stops too soon, the drug may not kill all the bacteria. You may become sick again, and the remaining bacteria may become resistant to the antibiotic that you’ve taken.
  • Do not skip doses. Antibiotics are most effective when they are taken regularly.
  • Do not save antibiotics. You might think that you can save an antibiotic for the next time you get sick, but an antibiotic is meant for your particular infection at the time. Never take leftover medicine. Taking the wrong medicine can delay getting the appropriate treatment and may allow your condition to worsen.
  • Do not take antibiotics prescribed for someone else. These may not be appropriate for your illness, may delay correct treatment, and may allow your condition to worsen.
  • Talk with your health care professional. Ask questions, especially if you are uncertain about when an antibiotic is appropriate or how to take it.

It’s important that you let your health care professional know of any troublesome side effects. Consumers and health care professionals can also report adverse events to FDA’s MedWatch program at 800-FDA-1088 or online at MedWatch.

Salt and Sugar in Infant and Toddler Foods

toddler

A report published in the journal Pediatrics shares information on a study that evaluated the sodium and sugar content of US commercial infant and toddler foods.

The study reviewed a 2012 nutrient database of 1074 US infant and toddler foods and drinks developed from a commercial database, manufacturer web sites, and major grocery stores. Products were categorized on the basis of their main ingredients and the US Food and Drug Administration’s reference amounts customarily consumed per eating occasion (RACC). Sodium and sugar contents and presence of added sugars were determined.

 The study found that all but 2 of the 657 infant vegetables, dinners, fruits, dry cereals, and ready-to-serve mixed grains and fruits were low sodium (140 mg/RACC). The majority of these foods did not contain added sugars; however, 41 of 79 infant mixed grains and fruits contained 1 added sugar, and 35 also contained >35% calories from sugar. Seventy-two percent of 72 toddler dinners were high in sodium content (>210 mg/RACC). Toddler dinners contained an average of 2295 mg of sodium per 1000 kcal (sodium 212 mg/100 g). Savory infant/toddler snacks (n = 34) contained an average of sodium 1382 mg/1000 kcal (sodium 486 mg/100 g); 1 was high sodium. Thirty-two percent of toddler dinners and the majority of toddler cereal bars/breakfast pastries, fruit, and infant/toddler snacks, desserts, and juices contained 1 added sugar.

Commercial toddler foods and infant or toddler snacks, desserts, and juice drinks are of potential concern due to sodium or sugar content.

Study researchers advise physicians to speak to parents about carefully reviewing nutrition labels when selecting commercial toddler foods, and to limit salty snacks, sweet desserts, and juice drinks. They add that reducing excessive amounts of these ingredients from birth to 24 months can lead to better infant and toddler health now and as they grow.

 

 

Medicines Can Hurt…Use and Store Carefully

medicines

Each year, nearly  500,000 calls to the Poison Control Center are about children ingesting medicines that belong predominately to parents and grandparents.

Safe Kids Worldwide shares the following tips about keeping your child safe from medicines that could have serious consequences for them.

Store Medicines Safely

  • Put all medicines up and away and out of sight including your own. Make sure that all medicines and vitamins are stored out of reach and out of sight of children. In 3 out of 4 emergency room visits for medicine poisoning, the child got into medicine belonging to a parent or grandparent.
  • Consider places where kids get into medicine. Kids get into medication in all sorts of places, like in purses and nightstands.  In 67% of emergency room visits for medicine poisoning, the medicine was left within reach of a child, such as in a purse, on a counter or dresser, or on the ground. Place purses and bags in high locations, and avoid leaving medicines on a nightstand or dresser.
  • Consider products you might not think about as medicines. Most parents store medicine up and away – or at least the products they consider to be medicine. They may not think about products such as diaper rash remedies, vitamins or eye drops as medicine, but they actually are and need to be stored safely.
  • Close your medicine caps tightly after every use. Choose child-resistant caps for medicine bottles, if you’re able to. If pill boxes or non-child resistant caps are the only option, it’s even more important to store these containers up high and out of sight when caring for kids. And remember, child-resistant does not mean child-proof, and some children will still be able to get into medicine given enough time and persistence.
  • Be alert to visitors’ medicine. Guests in your home may not be thinking about the medicine they brought with them in their belongings. In 43% of emergency room visits for medicine poisoning, the medicine a child got into belonged to a relative, such as a grandparent, aunt or uncle. When you have guests in your home, offer to put purses, bags and coats out of reach of children to protect their property from a curious child.
  • Be alert to medicine in places your child visits. You know to store medicine safely in your home, but do you ever think about medicine safety when your child isn’t at home? Asking people your child visits to put their medicines in a safe place works for some parents, but it may feel socially awkward to others.  Another option is to take a look around to see if any medicines are stored within reach and deal with any risks in sight.
  • Even if you are tempted to keep it handy, put medicine out of reach after every use. When you need to give another dose in just a few hours, it may be tempting to keep medicine close at hand. But accidents can happen fast, and it only takes a few seconds for children to get into medicine that could make them very sick. Put medicine up and away after every use. And if you need a reminder, set an alarm on your watch or cell phone, or write yourself a note.

Give Medicines Safely

  • Use the dosing device that comes with the medicine. Proper dosing is important, particularly for young children. Kitchen spoons aren’t all the same, and a teaspoon and tablespoon used for cooking won’t measure the same amount as the dosing device.
  • Keep all medicines in their original packages and containers.
  • Take the time to read the label and follow the directions. Even if you have used the medicine before, sometimes the directions change about how much medicine to give.
  • Even if your child seems really sick, don’t give more medicine than the label says. It won’t help your child feel better faster, and it may cause harm.
  • Read the label and know what’s in the medicine. Take the time to read the label and follow the directions on your child’s medicine. Check the active ingredients listed on the label. Make sure you don’t give your child more than one medicine with the same active ingredient, because it puts your child at risk for an overdose.

Communicate to Caregivers

  • If you are depending on someone else to give your child medicine, communicate clearly to avoid double dosing or dosing errors. More than 67,000 parents call poison control centers about dosing errors each year.
  • Write clear instructions to other caregivers, including what medicine to give, when to give it and the correct dose.

Get Rid of Medicines Safely

  • Clean out your medicine cabinet. Reduce the risk of kids getting into medicine by getting rid of unused or expired medicine. Many communities have a medicine take-back program. This is an easy way to get rid of your unused or expired medicines.
  • To dispose of it yourself, pour the medicine into a sealable plastic bag. If the medicine is a pill, add water to dissolve it. Then add kitty litter, sawdust or coffee grounds to the plastic bag. You can add anything that mixes with the medicine to make it less appealing for children or pets.
  • The Food and Drug Administration (FDA) says that certain medicines are so dangerous they should be flushed down the toilet.

Talk to Your Kids about Medication Safety

  • Talk to your kids about medication safety. Even if their medicine tastes good, don’t compare it to candy to encourage kids to take it.
  • Speak with older kids about the dangers of misusing or abusing prescription or over-the-counter medicines.

Educate Grandparents

  • It is estimated that in 38 percent of ER visits involving a medicine poisoning, the medicine belonged to a grandparent. Talk to grandparents about being extra mindful with medicine or pillboxes when children are around.
  • Don’t forget to remind other family members and visitors as well.

Put the Poison Help Number in Your Phone

  • Put the toll-free number for the Poison Control Center (1-800-222-1222) into your home and cell phones. You can also put the number on your refrigerator or another place in your home where babysitters and caregivers can see it. And remember, the poison help number is not just for emergencies, you can call with questions about how to take or give medicine.
  • If your child has collapsed, is not breathing, or has a seizure, call 911.
  • Do not make children vomit or give them anything unless directed by a professional.

You can download these tips here.

Download Tips

 

Stuttering

stutteringAccording to the Stuttering Foundation (www.stuttersfa.org) more than 68 million people worldwide stutter, which is about 1% of the population.

In the United States, that’s over 3 million Americans who stutter.  Four times as many males as females have a problem with stuttering.

Most people who saw The King’s Speech were touched by the life-long impact that stuttering had on King George the 6th of Britain.This movie continues to create a renewed public interest in the causes and latest treatments for stuttering.

The Stuttering Foundation describes stuttering as “A communication disorder in which the flow of speech is broken by repetitions (li-li-like this), prolongations (lllllike this), or abnormal stoppages (no sound) of sounds and syllables. There may also be unusual facial and body movements associated with the effort to speak. Stuttering is also referred to as stammering.”

Contrary to the commonly held belief that stuttering is caused by trauma, or emotional problems,  the Stuttering Foundation identifies four causes for stuttering. They are: genetics (approximately 60% of those who stutter have a family member who does also); child development (children with other speech and language problems or developmental delays are more likely to stutter); neurophysiology (recent neurological research has shown that people who stutter process speech and language slightly differently than those who do not stutter); and family dynamics (high expectations and fast-paced lifestyles can contribute to stuttering). Stuttering may occur when a combination of factors come together and may have different causes in different people. It is probable that what causes stuttering differs from what makes it continue or get worse.

About 5 percent of all children go through a period of stuttering that lasts six months or more. Three-quarters of whom will recover by late childhood, leaving about 1% with a long-term problem. The best prevention tool is early intervention.

We all know that stuttering can cause a child to become self-conscious about speaking. It can also make him or her the brunt of jokes and ridicule from insensitive children in school or when out playing.  It is best to seek ways to  help as soon as possible. (check out If You Think Your Child is Stuttering for ways to help immediately) If the stuttering persists beyond three to six months or is particularly severe, it may be time to seek help from a speech-language pathologist who specializes in stuttering . (check out speech-language pathologists for listings by state or country.)

There are a variety of successful approaches for treating both children and adults (check out Why Speech Therapy? for some guidelines).

While there are no instant miracle cures for stuttering, a specialist in stuttering can help not only children but also teenagers, young adults, and even older adults improve their speech.

Before You Try a Weight Loss Supplement…

weightMany of us have vowed to lose weight in 2015. We all would like to find a quick fix, an easier path than dieting and exercising. We may be tempted to try one of those miracle weight loss supplements or foods. Before you do, please read what the FDA has to say about weight loss products.

Many so-called “miracle” weight loss supplements and foods (including teas and coffees) don’t live up to their claims. Worse, they can cause serious harm, say FDA regulators. The agency has found hundreds of products that are marketed as dietary supplements but actually contain hidden active ingredients (components that make a medicine effective against a specific illness) contained in prescription drugs, unsafe ingredients that were in drugs that have been removed from the market, or compounds that have not been adequately studied in humans.

“When the product contains a drug or other ingredient which is not listed as an ingredient we become especially concerned about the safety of the product,” says James P. Smith, M.D., an acting deputy director in FDA’s Office of Drug Evaluation.

Tainted Products

For example, FDA has found weight loss products tainted with the prescription drug ingredient sibutramine. This ingredient was in an FDA-approved drug called Meridia, which was removed from the market in October 2010 because it caused heart problems and strokes.

“We’ve also found weight-loss products marketed as supplements that contain dangerous concoctions of hidden ingredients including active ingredients contained in approved seizure medications, blood pressure medications, and antidepressants,” says Jason Humbert, a senior regulatory manager at FDA. Most recently, FDA has found a number of products marketed as dietary supplements containing fluoxetine, the active ingredient found in Prozac, a prescription drug marketed for the treatment of depression and other conditions. Another product contained triamterene, a powerful diuretic (sometimes known as “water pills”) that can have serious side-effects and should only be used under the supervision of a health care professional.

Many of these tainted products are imported, sold online, and heavily promoted on social media sites. Some can also be found on store shelves.

And if you’re about to take what you think of as “natural” dietary supplements, such as bee pollen or Garcinia cambogia, you should be aware that FDA has found some of these products also contain hidden active ingredients contained in prescription drugs.

“The only natural way to lose weight is to burn more calories than you take in,” says James P. Smith, M.D. That means a combination of healthful eating and physical activity.

Dietary Supplements are not FDA-Approved

Under the Federal Food, Drug and Cosmetics Act (as amended by the Dietary Supplement Health and Education Act of 1994), dietary supplement firms do not need FDA approval prior to marketing their products. It is the company’s responsibility to make sure its products are safe and that any claims made about such products are true.

But just because you see a supplement product on a store shelf does not mean it is safe, Humbert says. FDA has received numerous reports of harm associated with the use of weight loss products, including increased blood pressure, heart palpitations (a pounding or racing heart), stroke, seizure and death. When safety issues are suspected, FDA must investigate and, when warranted, take steps to have these products removed from the market.

FDA has issued over 30 public notifications and recalled 7 tainted weight loss products in 2014. The agency also has issued warning letters, seized products, and criminally prosecuted people responsible for marketing these illegal diet products. In addition, FDA maintains an online list of tainted weight-loss products.

To help people with long-term weight management, FDA has approved prescription drugs such as Belviq, Qysmia, and Contrave, but these products are intended for people at least 18 years of age who:

  • have a body mass index (BMI, a standard measure of body fat) of 30 or greater (considered obese); or
  • have a BMI of 27 or greater (considered overweight) and have at least one other weight-related health condition.

Moreover, if you are going to embark on any type of weight control campaign, you should talk to your health care professional about it first, Welch says.

Know the Warning Signs

Look for potential warning signs of tainted products, such as:

  • promises of a quick fix, for example, “lose 10 pounds in one week.”
  • use of the words “guaranteed” or “scientific breakthrough.”
  • products marketed in a foreign language.
  • products marketed through mass e-mails.
  • products marketed as herbal alternatives to an FDA-approved drug or as having effects similar to prescription drugs.

Advice for Consumers

Generally, if you are using or considering using any product marketed as a dietary supplement, FDA suggests that you:

  • check with your health care professional or a registered dietitian about any nutrients you may need in addition to your regular diet.
  • ask yourself if it sounds too good to be true.
  • be cautious if the claims for the product seem exaggerated or unrealistic.
  • watch out for extreme claims such as “quick and effective” or “totally safe.”
  • be skeptical about anecdotal information from personal “testimonials” about incredible benefits or results from using a product.

If you suspect a product marketed as a dietary supplement sold online may be tainted, FDA urges you to report that information online. You or your health care professional can also report an illness or injury you believe to be related to the use of a dietary supplement by calling 1-800-FDA-1088 or visiting FDA online.

This article appears on FDA’s Consumer Updates page, which features the latest on all FDA-regulated products.

Updated January 5, 2015