Oral iron therapy: Current concepts and future prospects for improving efficacy and outcomes

Iron deficiency (ID) and iron-deficiency anaemia (IDA) are global public health concerns, most commonly afflicting children, pregnant women and women of childbearing age. Pathological outcomes of ID include delayed cognitive development in children, adverse pregnancy outcomes and decreased work capacity in adults. IDA is usually treated by oral iron supplementation, typically using iron salts (e.g. FeSO4 ); however, dosing at several-fold above the RDA may be required due to less efficient absorption. Excess enteral iron causes adverse gastrointestinal side effects, thus reducing compliance, and negatively impacts the gut microbiome. Recent research has sought to identify new iron formulations with better absorption so that lower effective dosing can be utilized. This article outlines emerging research on oral iron supplementation and focuses on molecular mechanisms by which different supplemental forms of iron are transported across the intestinal epithelium and whether these transport pathways are subject to regulation by the iron-regulatory hormone hepcidin.

A survey of antibiotic outpatient prescribing and antibiotic self-medication

In order to assess patterns of antibiotic prescribing and self-medication, a survey was carried out of patients from Government and private hospitals (500 each) and of 1000 apparently healthy adults in Benin City, Nigeria. Ampicillin and tetracycline were the antibiotics commonly used for self-medication; the commonest reasons given for the self-medication were the treatment of sexually transmitted diseases, cough, stomach upsets and diarrhoea. Ampicillin was the commonest prescribed antibiotic; the commonest indications for prescription were soft-tissue, sexually transmitted, upper respiratory and gastro-intestinal infections. According to an assessment by four clinicians from a panel of eight in Government and private practice, 52% of the total prescriptions were judged to be appropriate whereas 30% were judged to be inappropriate by a majority of the physicians. The implications of this study for the control of bacterial resistance to antibiotics are discussed.