The Right Antibiotic

A letter from the CDC and others published online October 24 in JAMA Internal Medicine presents evidence that about half of patients thought to have bacterial otitis media, sinusitis, or pharyngitis are treated with the wrong antibiotic. First-line (correct) antibiotic therapy, according to the letter, would be amoxicillin or amoxicillin/clavulanate for otitis media or sinusitis […]

Weight Loss

The AspireAssist weight loss device, which was the subject of an article in our August 29 issue, provoked a flurry of articles and letters in the New York Times. The first of these, written by 2 directors of weight loss programs and published on September 10th, called the new device “the latest in a desperate […]

1500 Issues and Counting

The Medical Letter was founded in 1959 by Arthur Kallet, a layman, and Harold Aaron, an internist. Arthur was a co-founder of Consumer Research, which became Consumers Union, and he started the publication of Consumer Reports. Harold was on the advisory board of Consumers Union, and The Medical Letter was his idea. The early years […]

Put Statins in the Water?

An article later this year will update our 2014 article on Drugs for Lipids, and there is plenty of updating to do. Our 2014 article was published shortly after the American College of Cardiology and the American Heart Association recommended using risk factors rather than specific cholesterol targets as indications for statins. There is general […]

Generic Drugs

An article published online on May 9, 2016 in JAMA Internal Medicine (ME Johansen and C Richardson. Estimation of potential savings through therapeutic substitution.) presented estimates of “excess expenditure due to branded drug overuse when a lower-cost generic in the same class with the same indication was available” between 2010 and 2012. The “excess expenditure” […]

Statin Intolerance

The effectiveness of statins in lowering the risk of cardiovascular events in patients with elevated LDL-C is well established now, but muscle-related symptoms, often without increases in serum creatine kinase levels, have limited their use. An interesting study (SE Nissen et al) designed to ameliorate this problem was published in the April 19th issue of […]

NSAIDs Are Not So Safe Either

It’s hard to believe that opioid overdose now kills more people than car accidents in the US, but we’ve been told this so often that it must be true. Pressure is building on prescribers to use something else to treat most patients with chronic pain, and in many cases that something else will probably be […]