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Researchers recommend new pneumonia drug dosage for obese patients

A new study conducted by researchers at the Veterans Affairs Medical Center, which is affiliated with the Brown Alpert Medical School, examines the ideal dose of medicine for administration to obese and extremely obese patients presumed to have antibiotic-resistant pneumonia. The article was published online Sept. 6 in the journal Pharmacotherapy.

Typically, patients with pneumonia that is caused by the Staphylococcus aureus bacteria and that is resistant to the methicillin antibiotic are administered the antibiotic vancomycin. But obese patients may metabolize the drug at a different rate than other patients, and until recently there were no existing guidelines on the dosage they should receive.

The researchers found the ideal dosage for obese patients to be 30 mg of vancomycin per kilogram of body weight, compared to the standard guideline of 15 to 20 mg per kilogram of body weight. For extremely obese patients, the newly suggested guideline is 20 to 25 mg.

Haley Morrill, Aisling Caffrey, Eunsun Noh and Kerry LaPlante of the Veterans Affairs Medical Center collaborated on the study. LaPlante is also an adjunct associate professor of medicine at Alpert Medical School.

Study upholds value of flu vaccine for elderly

Vaccinating elderly patients against influenza lowers their likelihood of hospitalization or death, according to a study led by University researchers and published in the Journal of the American Geriatrics Society.

Each year, a new flu vaccine is created, but the vaccine strain does not always match the strain of flu most common during that year, reducing the immunity conferred by the vaccine and creating variation in the efficacy of the vaccine.

Some public health experts have questioned whether vaccinating the elderly is beneficial. To explore this question, the researchers compared the match between a year’s most common flu strain and vaccine with the mortality and hospitalization rates of the elderly population. The researchers predicted that, if the vaccines were indeed useful, then mortality and hospitalization rates would be lower when the match was closer.

Over the10-year span examined, closer matches between the most common strain and the vaccine corresponded to lower hospitalization and mortality rates among the elderly, leading the researchers to conclude that flu vaccinations are worthwhile for the elderly population.

“Annual vaccination is the only way to maximize the vaccine, no matter what the age,” said Stefan Gravenstein, adjunct professor of medicine and health services, policy and practice and a co-author of the paper, in a University press release.

Researchers create and test dehydration metric

Research led by an Alpert Medical School professor developed and tested a new point scale and decision tree to determine if a child suffers from severe dehydration.

“You could miss kids with severe dehydration and not apply the correct treatment, and you could overtreat kids who don’t need it, which wastes precious resources,” said Adam Levine, assistant professor of emergency medicine and lead author of the study, in a University press release.

To ameliorate this problem, the researchers devised systems that rely upon easily observable symptoms.

The scale requires the clinician to rate the patient’s general appearance, respiration, tears and results of a skin pinch — a procedure of recording how long it takes skin to return to its normal state after being pinched. Similarly, the decision tree comprises two steps — first assessing physical appearance and then either eye appearance or results of a skin pinch. Based on the assigned point values or result of the decision tree, the clinician can immediately diagnose and treat the child for severe dehydration if deemed necessary.

The scale and the decision tree were tested in Bangladesh where cholera- and infection-induced dehydration are serious public health issues. Accurate prediction of severe dehydration was found to correlate strongly with both the tree and the scale.


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