Anaphylaxis to drug excipients

Antibiotics Usage and Avoidance in Germany and Poland: Attitudes and Knowledge of Patients, Physicians, and Pharmacists

Introduction: Antimicrobial resistance poses a significant global health threat, partly due to the overprescription of antibiotics. Understanding prescribers' behaviors and identifying knowledge gaps and misconceptions are essential for addressing antibiotic misuse and inappropriate use. Methods: Through online questionnaires, this study surveyed key stakeholders in outpatient antibiotic use in Germany (DE) and Poland (PL), including patients, physicians, and pharmacists. Results: Despite generally good knowledge about antibiotics, discrepancies exist between physicians' perceptions and patients' actual expectations regarding antibiotic prescriptions. Physicians often misjudge patients' attitudes toward antibiotics, with many patients having a neutral stance. This study found a strong physician interest in non-antibiotic treatments and patient willingness to engage with information about antibiotics. Conclusions: Improved communication between healthcare providers and patients was identified as a potential measure for enhancing antimicrobial stewardship, with education on effective alternative treatments, such as symptomatic therapies, as a likely strategy to reduce antibiotic reliance.

Inconsistent excipient listings in DailyMed: implications for drug safety

Excipients, or inactive ingredients, are a frequent cause of medication intolerance and allergy. Patients and clinicians concerned about medication allergies and sensitivities rely on the U.S. National Library of Medicine's DailyMed for accurate lists of excipients. Based on our anecdotal discovery of several examples of excipient omissions, we wished to examine the accuracy of DailyMed's listings more systematically in a sample of commonly prescribed medications. The objective of the study is to identify the frequency of inconsistency of excipient reporting within the DailyMed website. We performed a database audit of the Structured Product Labeling XML file provided by the drug manufacturer to the Food and Drug Administration and DailyMed for two randomly selected formulations of each of 50 commonly prescribed medications. For each of the 100 formulations, we compared the excipients listed in the "Description" to those in the "Ingredients and Appearance" sections in DailyMed. The Structured Product Labeling data file provided by the drug manufacturer contained internal inconsistencies of excipients in 39% of the formulations examined. Despite the use of Structured Product Labeling, the drug manufacturer's medication labels provided to the FDA and reported by DailyMed often contain conflicting information about inactive ingredients. Patients with allergies and excipient sensitivity should be aware of these discrepancies and consult multiple sections of the label to identify potential allergy-inducing inactive ingredients.