JAMA : the journal of the American Medical Association
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Metformin is widely viewed as the best initial pharmacological option to lower glucose concentrations in patients with type 2 diabetes mellitus. However, the drug is contraindicated in many individuals with impaired kidney function because of concerns of lactic acidosis. ⋯ Available evidence supports cautious expansion of metformin use in patients with mild to moderate chronic kidney disease, as defined by estimated glomerular filtration rate, with appropriate dosage reductions and careful follow-up of kidney function.
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Are antibiotics associated with improved outcomes in patients with acute bronchitis? ⋯ Prescribing antibiotics for acute bronchitis was associated with reduced overall and nighttime cough and with an approximately half-day reduction in duration of cough, in days feeling ill, and in days with impaired activities. However, at follow-up, there were no significant differences in patients receiving antibiotics compared with those receiving placebo in overall clinical improvements or limitations in work or other activities. There was a significant increase in adverse effects in the antibiotic group, particularly gastrointestinal symptoms.