Newsbriefs: Supplements; Immunization; Antibiotics; CDI

Vitamin & Mineral Supplements after Age 50.

A recent study published in Nutrients, Nov. 23, 2017, found that about 52 percent of adults age 65 and older have substandard levels of vitamin D, while 27 percent have suboptimal levels of vitamin B12. According to an article published in the JAMA Network Reader on Feb 5, 2018, a healthy diet provides a variety of nutritionally important micronutrients that interact with one another, derived from a broad range of foods. Multivitamin and multimineral supplements provide isolated compounds of these nutrients in a highly concentrated form, and are not recommended for generally healthy adults. The recommendation for vitamin B12 intake for adults over 50 is 2.4 micrograms (mcg)/day. As a comparison, one serving of fortified breakfast cereal contains 6.0 mcg. Vitamin B12 is naturally found in animal products, including fish, meat, poultry, eggs, milk, and milk products, and in fortified breakfast cereal. It is not present in plant foods. Current recommendations for vitamin D are 600 IU/day for adults up to age 70, and 800 IU/day for those older than 70. Food sources of vitamin D include fortified breakfast cereal and milk, eggs, cheese, mushrooms, and fatty fish, such as salmon. Vitamin D also is obtained from sunlight, which activates a mechanism in the body that converts sunlight to vitamin D. The current recommendation for calcium is 1,000 milligrams/day for men and 1,200 for women age 70 and older. It is important also to be aware that some supplements can decrease the effectiveness of certain medications, such as vitamin K and warfarin (Coumadin, a blood thinner), for example.

Revised Adult Immunization Schedule for 2018 Includes Changes for Shingles and MMR.

The CDC’s Advisory Committee on Immunization Practices’ 2018 immunization schedule for adults was published recently in the Annals of Internal Medicine. This includes changes for shingles and measles, mumps, rubella (MMR). Shingles: Two doses of the newly approved, recombinant zoster vaccine (RZV—Shingrix) are recommended for adults aged 50 and older. Those who have already received the live zoster vaccine (Zostavax) may receive their first RZV dose at least two months later. Adults aged 60 and older may receive either vaccine, but RZV is preferred. Mumps: Adults who have received two or fewer doses of a mumps-containing vaccine and are at risk for contracting mumps during a local outbreak should receive a dose of the measles, mumps, and rubella (MMR) vaccine.

“Forgotten” Drug Could Be Foundation for New Generation of Antibiotics.

Octapeptins, discovered in the late 1970s but not selected for further development at that time, has been synthesized by researchers at the University of Queensland’s (Australia) Institute for Molecular Bioscience, increasing its effectiveness against drug-resistant bacteria. Professor Matt Cooper, Director of the Institute’s Centre for Superbug Solutions, said the study was initiated in response to the need for new drugs to fight drug-resistant bacteria, called Gram-negative bacteria. These bacteria include E. coli, gonorrhea-causing bacteria and cholera-causing bacteria, life-threatening infections. The research was published in the Journal of Cell Chemical Biology, Jan. 25, 2018.

Fecal Microbiota Oral Capsule Effective as Colonoscopy for Transplantation.

Recurring bouts of Clostridium difficile infection (CDI) can be treated as effectively with oral capsules containing fecal microbiota as with colonoscopy, according to results of a recent randomized trial. In the trial, half the participants received transplantation via capsule, and the other half via colonoscopy. Prevention of recurrent episodes of CDI was 96 percent in both groups after a single fecal microbiota transplant. Two participants in each group developed recurring CDI, but were treated successfully with a second treatment. No infectious complications occurred in either group. (Clostridium difficile is now called Clostridioides difficile, according to the Clinical and Laboratory Standards Institute, in an update issued in February 2018).

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