{"id":113,"date":"2007-02-12T11:57:16","date_gmt":"2007-02-12T10:57:16","guid":{"rendered":"http:\/\/resource.bmj.com\/bmj\/2007\/02\/12\/lancet-10-feb-2007\/"},"modified":"2007-02-12T11:57:16","modified_gmt":"2007-02-12T10:57:16","slug":"lancet-10-feb-2007","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2007\/02\/12\/lancet-10-feb-2007\/","title":{"rendered":"Lancet  10 Feb 2007"},"content":{"rendered":"<p>The <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602347\/fulltext\">cyclo-oxygenase 2 inhibitors<\/a><strong> <\/strong>came out amidst a fanfare of publicity about their <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602347\/fulltext\">gastrointestinal safety<\/a>, though from the start, a few discordant notes were sounded by cost\/benefit analysts. <!--more-->Then came the discovery of their cardiovascular risks, and hurried comparisons with the entire range of NSAID drugs, all of which were shown to carry risk, apart from aspirin and naproxen. We now know that both <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602347\/fulltext\">diclofenac<\/a><strong> <\/strong>and <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602347\/fulltext\">etoricoxib <\/a>are associated with a similar increase in cardiovascular events (about two-fold) \u2013 but is the latter any safer in terms of GI bleeding? By nearly a third, say the <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602347\/fulltext\">MEDAL<\/a> investigators. In defiance of standard pharmacological teaching, this even extends to patients co-prescribed low-dose aspirin.<\/p>\n<p><strong><\/strong>I have previously stated my intention of searching the <em>Institutes of Religion <\/em>by John Calvin to find the place where he warns the Elect against the excessive <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602359\/fulltext\">prescribing of antibiotics<\/a>. The great majority of modern sermons on the subject come from Calvinist countries \u2013 see the <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602086\/fulltext\">sermon from Scotland on p. 442<\/a> or indeed listen to one from the Netherlands on the <em>Lancet <\/em>website. As an obdurate sinner, cut off from Grace and doomed to Perdition in this as in so many other respects, I can\u2019t say that I am too impressed with this simple <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602359\/fulltext\">study <\/a>which shows that giving <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602359\/fulltext\">macrolide antibiotics<\/a><strong> <\/strong>to healthy volunteers increases their resident throat population of <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602359\/fulltext\">macrolide-resistant streptococci<\/a>. This is what you\u2019d expect. I am more intrigued by the fact that most streptococci remain fully penicillin-sensitive after 60 years of \u201cover-use<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The cyclo-oxygenase 2 inhibitors came out amidst a fanfare of publicity about their gastrointestinal safety, though from the start, a few discordant notes were sounded by cost\/benefit analysts. [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2007\/02\/12\/lancet-10-feb-2007\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":38363,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[111],"tags":[],"class_list":["post-113","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-richard-lehmans-weekly-review-of-medical-journals"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Lancet 10 Feb 2007 - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2007\/02\/12\/lancet-10-feb-2007\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Lancet 10 Feb 2007 - The BMJ\" \/>\n<meta property=\"og:description\" content=\"The cyclo-oxygenase 2 inhibitors came out amidst a fanfare of publicity about their gastrointestinal safety, though from the start, a few discordant notes were sounded by cost\/benefit analysts. 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