July 1, 2010
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Every year about this time, I see a couple of unhappy local residents who present with an intensely pruritic, erythematous papular mystery rash. In contrast to flea bites, which are simple raised papules, the lesions seem umbilicated or have a central bite mark.
A rifamycin antibacterial agent has been approved for treating patients with hepatic encephalopathy (HE). Rifaximin is a minimally absorbed oral antimicrobial that was originally approved in 2004 for the treatment of travelers' diarrhea caused by Escherichia coli. It is marketed by Salix Pharmaceuticals as Xifaxan®.
Drug-related hepatotoxicity during treatment for tuberculosis is a common barrier to initiation of antimycobacterial. While most hepatotoxicity results in minimal to no gastrointestinal complaints, some patients experience significant nausea, anorexia, vomiting, or abdominal pain.
In this issue: New reports about proton pump inhibitors and the effects of gastric suppression, pioglitazone vs vitamin E for non-alcoholic steatohepatitis, metformin and vitamin B12 deficiency, and FDA Actions.