The consumer model is able to explain only to a modest extent the variation in satisfaction, but dissatisfaction is a good predictor of the intention to change doctors.
Antibiotic treatment, day-care center (DCC) attendance and young age are associated with penicillin-non-susceptible Streptococcus pneumoniae (PNSSp) carriage. Yet, it is unclear whether each is an independent risk factor for the individual. This cross-sectional surveillance study was designed to answer this question. Nasopharyngeal cultures were obtained from 429 children (< 6 y) during a visit to the pediatrician's office. Two risk rates were calculated: the individual's absolute risk to carry PNSSp [simple odds ratio (ORS)] and the risk of an individual who is already a carrier [conditional odds ratio (ORC)]. Streptococcus pneumoniae was isolated from 52.7% of 401 children. PNSSp was detected in 37.1% of carriers. Independent risk factors were: young age [ORS 2.24, 95% confidence interval (95% CI) 1.2-4.2], DCC attendance (ORS 3.8, 95% CI 1.9-7.5), having young siblings (ORS 2.3, 95% CI 0.95-5.57) and each antibiotic treatment during the previous 3 months (ORS 1.5, 95% CI 1.25-1.85). The only significant risk factor among carriers was prior antibiotic treatment (ORC 2.24, 95% CI 1.64-3.05). Young children, who attended DCC and received 1 antibiotic course (9% of the population) had a risk 12.9 times higher than children without these features.
We found insufficient evidence to indicate major differences in UGIT adverse effects related to use of daily generic, as compared with brand, alendronates.
BACKGROUND
Concerns have been raised regarding potential increased risk of UGIT adverse effects with generic alendronate formulations.
PATIENTS AND METHODS
In a retrospective database analysis of health resource utilization related to UGITO, we compared rates of: new use of UGIT medications (H2 blockers and proton pump inhibitors), gastroenterology specialist (GE) visits, and UGIT endoscopies, and total hospital admissions, in patients treated for > 3 months with: brand alendronate 10 mg/d (n=2875), generic 1 (Teva, Israel) 10 mg/d (n=1244), generic 2 (Unipharm, Israel) 10 mg/d (n=1088) and brand alendronate 70 mg/week (n=6893).
RESULTS
Rates of new use of UGIT medications (5.7%, 4.7%, 4.9% and 4.0% respectively) and of GE visits (0.8%, 0.7%, 0.3% and 0.8%) respectively) were not significantly different among the 4 formulations (all comparisons adjusted for age and concomitant use of NSAIDs). Endoscopies totaled 58, respective rates were 0.3%, 0.7% 1.1% and 0.4%, with generic 2 significantly higher compared to brand 70 mg/weekly, O.R. (95% CL): 3.0 (1.4–6.5). The most common findings were hiatus hernia or mild‐moderate reflux esophagitis. Hospital admissions rates were not different: 4.9%, 5.2%, 4.5% and 3.6% respectively.
CONCLUSIONS
Our findings, expressed in 1/4 outcome variables, indicate possible variation in patient symptoms and/or physician responses, during treatment with different generic alendronate formulations.
Clinical Pharmacology & Therapeutics (2005) 79, P71–P71; doi:
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