respiratory tract infection
Antibiotics seem to have little effect on duration of a cough.
* THE QUESTION When plagued by a persistent cough, people often beg their doctor for relief. But would taking an antibiotic make a difference in their symptoms?
* THIS STUDY randomly assigned 807 children and adults with lower respiratory tract infections characterized by coughing to one of three treatment groups. One group was given an immediate prescription for an antibiotic (amoxicillin or erythromycin); the second group was given a prescription but asked to wait two weeks before taking the drug; the third was given basic medical advice but not offered an antibiotic. Three weeks later, the groups reported little difference in the length or severity of their symptoms: Coughs persisted about 12 days, and participants had felt sick, had trouble sleeping and had engaged in less activity for about the same amount of time.
* WHO MAY BE AFFECTED BY THESE FINDINGS? Anyone with a lower respiratory tract infection, one of the most common reasons people visit a doctor.
* CAVEATS Findings were based on data recorded by the participants or their parents in symptom diaries. One author had received consultancy fees from a pharmaceutical company for work on respiratory tract infections; another worked for a drug company.
* FIND THIS STUDY June 22/29 issue of the Journal of the American Medical Association; abstract available online at www.jama.com.
* LEARN MORE ABOUT antibiotics at www.cdc.gov/drugresistance and www.familydoctor.org.
Elastic stockings may reduce a health risk of lengthy flights.
* THE QUESTION When airplane flights last for several hours, the combination of limited leg room, decreased pressure in the cabins, a generally dry environment and little moving around can lead to more than the desire to stretch your legs. Some people develop dangerous blood clots in their legs. Might wearing compression stockings prevent this?
* THIS STUDY reviewed the data from nine studies that had randomly assigned 2,482 people taking flights of seven hours or more to wear knee-high elasticized compression stockings or to dress as usual. All participants were encouraged to walk around, drink water, avoid salty foods and keep baggage out of the way of their legs during their flights. Based on ultrasound scans given before and after the flights, two people who wore compression stockings developed blood clots deep in their legs (deep-vein thrombosis), compared with 46 people who did not wear the stockings. In a smaller group of people also checked for clots in veins close to the surface of the skin (superficial venous thrombosis), the occurrence rate was similar for those who did and did not wear the stockings (four of 826 vs. seven of 823).
* WHO MAY BE AFFECTED BY THESE FINDINGS? People taking long flights. The risk of a deep-vein clot is that it can travel through the bloodstream and lodge in a lung, possibly causing death.
* CAVEATS Analysis of the ultrasound scans may have been biased by the technicians' knowledge of whether people had worn compression stockings. The degree to which other preventive measures taken during the flights affected the outcomes was not evaluated. Any clots that developed after the ultrasound scans were taken were not included in the analyses.
* FIND THIS STUDY July issue of the Journal of Advanced Nursing; abstract available online at www.journalofadvancednursing.com (find Vol. 51, Issue 1).
* LEARN MORE ABOUT deep-vein thrombosis at http://ohp.nasa.gov/alerts (click "Health Alerts Archive") and www.nhlbi.nih.gov/health (search for "DVT").
A short course of drugs may be as good as a long regimen.
* THE QUESTION The virus that causes hepatitis C generally is treated with drugs taken for at least six months to quell possible liver damage. Might a shorter course treatment be equally effective?
* THIS STUDY randomly assigned 283 adults with hepatitis C to take the standard drugs (peginterferon alpha-2b and ribavirin) for either 12 or 24 weeks. Six months after treatment ended, the virus was no longer detectable in 76 percent of the 24-week group and 77 percent of the 12-week group. Among those who had no detectable virus when their treatment ended, 4 percent of the longer-treated group and 9 percent of those who had gotten shorter treatment had experienced a relapse within six months. Side effects, including depression and thyroid problems, occurred in 6 percent of the 12-week group and 13 percent of the 24-week group.
* WHO MAY BE AFFECTED BY THESE FINDINGS? People with hepatitis C, which most often is contracted via shared drug needles or unprotected sex but also can be passed from a pregnant woman to her baby. Nearly 4 million Americans have been infected with this virus.
* CAVEATS One of the 15 authors had received grants and speaking fees from Schering-Plough, which makes the drugs used in the study.
* FIND THIS STUDY June 23 issue of the New England Journal of Medicine; abstract available online at www.nejm.org.
* LEARN MORE ABOUT hepatitis C at www.cdc.gov (click on "A-Z Index") and http://digestive.niddk.nih.gov.
-- Linda Searing
The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.