Many studies have linked proton pump inhibitor (PPI) use to several adverse effects including Clostridium difficile-associated diarrhea, community-acquired pneumonia, bone fractures, and nutritional deficiencies. Other reports have linked PPI use with chronic kidney disease, cognitive decline, myocardial infarction (MI), stroke, and even death. Many patients take PPIs chronically and may be concerned about the risk of these side effects. This poses a challenge for healthcare providers as safety data has been primarily based on retrospective and observational studies. A recently pre-planned analysis using data from the prospective COMPASS study sheds some reassuring light.
Guest Authors: Hindu Rao, PharmD and Jelena Lewis, PharmD, BCACP, APh
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Colorectal cancer (CRC) is the second most common cause of cancer-related mortality in the United States. Screening is imperative because the early stages of CRC are often asymptomatic.Colonoscopy is an effective and widely employed screening option for CRC. Suboptimal bowel preparation is a problem in more than 20% of colonoscopy procedures, which reduces adenoma detection rates (ADR). Day-before, split-dose, and same-day regimens are options for colon cleansing prior to a colonoscopy. Is one better than another in terms of tolerability and colorectal cancer detection?
The list of regimens for Helicobacter pylori eradication is longer than ever. In recent years, American and European guidelines have recommended clarithromycin-based triple therapy or bismuth-containing quadruple therapy for primary treatment of H. pylori infection. However, increasing resistance to these regimens has forced us to consider alternative treatments, including but not limited to: the addition of probiotics, use of sequential regimens, and the inclusion of levofloxacin in the antibiotic cocktail. With all these choices, the clinician is left wondering what the best option is.