Ketek keep-away You may remember telling you about the drug Ketek. More specifically, you may remember me telling you to stay away from it. Well, I was right.
This drug was originally approved for treating strains of strep throat and pneumonia that are resistant to other macrolide drugs (a group of antibiotics), but it's only recommended for adults, and it's thought to have its share of negative side effects, including the risk of severe liver damage.
So why not test it on children? Well apparently one group of researchers thought it was a good idea. And they couldn't have been more wrong.
While running a clinical trial the drug's effects on tonsillitis and ear infections, evidence emerged stating that this drug could be deadly (just months after researchers reported that three other patients actually died from liver failure caused by Ketek), and health experts started calling for the trials to be cut off. Of course they weren't, and the FDA refuses to take this drug off the shelves.
They say the benefits outweigh the consequences.
Well, let me ask you something. What would you rather have? An ear infection and strep throat, or permanent, irreversible, and possibly deadly liver damage?
And possible liver damage is just one possible problem. You can add to the list the risk of eye and heart problems too.
The fact is, there are other options out there for treating pneumonia and strep throat, without resorting to a drug whose side effects almost defeat the purpose of getting well in the first place.
If you do find yourself sick with pneumonia or strep, and your doctor recommends this drug, tell him you're worried about liver damage and ask him what the other antibiotic options are. Strep throat probably won't kill you. But liver damage certainly could.
Pneumonia does require antibiotics. If you're sick enough to be in the hospital, your doctor has several powerful, intravenous antibiotics to choose from (usually rocephin, azithromycin, and levofloxacin), depending on the circumstances. For milder cases that don't require hospitalization, regular old penicillin, amoxicillin, and the oral forms of clarithromycin and levofloxacin will usually do.
If a patient has done well with a particular antibiotic in the past, I'll often go with that. The point here is that there are usually several older, tried-and-true antibiotics that can work just fine. Because of that, and given the newfound risk of liver problems, Ketek appears to me be a totally unnecessary new drug.
When it comes to strep throat, amoxicillin usually works just fine. But, since most sore throats are not strep throat, but are instead caused by viruses, you may not even need an antibiotic anyway. Most strep throats will actually clear up in a few days without an antibiotic. Nonetheless, I find more severe cases seems to clear up a day or so sooner with an antibiotic.
Whenever I prescribe an antibiotic, I also prescribe a probiotic supplement. Antibiotics don't just kill the harmful bacteria in your throat or lungs, they also kill healthy bacteria in your gut, which can cause an upset stomach and diarrhea.
The products PB8 and Kyodophilus both work well and are easy to find. Continue with the probiotic or yogurt for three days after completing the antibiotic, just to be on the safe side.
Despite overwhelming evidence of their benefit and safety, most doctors I know still fail to prescribe probiotics for this purpose. If your doctor ignores this simple measure, you can safely do it on your own.
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 There are times when medical news is too urgent to wait until the next issue, so Dr. Alan Inglis keeps in touch with you through House Calls.
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