Gilead's $1,000-a-pill antiviral remdesivir is no wonder drug. We knew this when it failed for hepatitis, the disease it was created for. And then when it failed for Ebola. And then again, when it failed for COVID-19. But like a bolt, in late April, a breakthrough: in a second trial for COVID-19 patients, remdesivir sped time to recovery—proof of benefit,
Read more...

On April 29th Anthony Fauci announced the National Institute of Allergy and Infectious Diseases, an institute he runs, had completed a study of the antiviral remdesivir for COVID-19. The drug reduced time to recovery from 15 to 11 days, he said, a breakthrough proving "a drug can block this virus." Now people are clamoring for $1,000-a-pill remdesivir. While the results were preliminary, unpublished, and unconfirmed by ...

Read more...

This time of COVID-19 has brought us to a scenario of scale and scope that most had never planned for. Whether you are at a small practice or a large one, you are likely looking for ways to rapidly evolve your business and patient care processes to survive this global pandemic. Many physician practices are trying to do more with less in terms of how and where they are spending their ...

Read more...

My patient was a young man who wanted to be placed back on buprenorphine. He had started using again. He often missed appointments, did not pick up phone calls. So when I saw him in the room, I masked my surprise. “What makes you want to start today?” I asked. “I live with my grandma,” he said. He could not keep leaving the house for heroin.

Of the many ...

Read more...

In 2002 pro baseball manager Billy Beane accomplished the impossible. He took the Oakland Athletics, a low-budget team comprised of unknown baseball players to the playoffs. The story’s magic is that he was able to compete with the Goliaths of the baseball world – the New York Yankees - with only a fraction of the budget. The idea is simple - draft players who are statistically successful in their respective ...

Read more...

The Joint Commission of Hospital Accreditation requires hospitals to ask the patient for their level of pain, just subjectively. They require we use a 10-point scale, from 0 for no pain to 10 being the worst pain ever. I knew instinctively that this was a bad thing and would lead to more narcotic addiction, as it did eventually. But in our patients, the pain scores went down as we detoxified patients ...

Read more...

Sometimes, old ideas and time-tested treatments remain the best. Newer doesn’t always mean better. Except in the case of one of our oldest antihistamines, tried-and-true Benadryl. It is time for that old drug to be retired, sent off to pasture, and never used again. Goodbye, Benadryl. Fare thee well, adieu, and don’t let the door hit you on the way out. Benadryl (diphenhydramine) was introduced in 1946. The top single that ...

Read more...

Imagine a looming global crisis that threatens the health of countless people, confounding scientists and governments with its sheer magnitude and complexity and growing at a pace that will quickly exceed our ability to reverse course. Sounds a little like climate change, right? The existential threat I'm referring to in this case is microscopic: antibiotic-resistant bacteria and fungi. In a way, antibiotic resistance is the climate change of medicine. It has potentially lethal ...

Read more...

At least a few times a year, I am asked to prescribe antibiotics to people who are not my patients. From my point of view, there is only one answer that makes sense here – no. I have the same reaction when patients call me for a refill or advice when I have not seen them in a year or two. The patient may feel that I will refill their ...

Read more...

"Boxed warnings" or "black boxes" are the strictest FDA label warnings. They appear on cigarettes, fluoroquinolones (for tendon rupture), Lamictal (for SJS and TEN), Accutane (birth defects), and other products with well-known risks. The industry obviously dislikes black boxes since they reduce sales (though their lobbyists charge the boxes "confuse" and "unnecessarily alarm" patients). So it was no surprise that when the
Read more...

94 Pages

Most Popular

✓ Join 150,000+ subscribers
✓ Get KevinMD's most popular stories