Avoidable risk?

Last fall saw a frightening outbreak of fungal meningitis that resulted in the severe illness of almost 700 people and, tragically, the deaths of 45 others. Contaminated steroid injections were found to be the cause.

The Institute for Safe Medication Practices now reports that 13% of pharmacists found contamination in their supposedly sterile, compounded (made in the pharmacy) drugs last year, and almost 75% fear that such a horrific outbreak could happen again.

Several agencies are swaming the compounding pharmacies in a belated attempt to make sure it doesn’t happen again. But will their efforts be enough?

Maybe, but there is always a risk with any treatment.

Art Caplan, the well-known bioethicist, wrote a column during the early part of the outbreak that called into question the scientific validity of epidural spinal injections. According to Caplan, “the evidence is not convincing that people do better with shots than pain relievers and anti-inflammatory drugs” and “too many of us are using spinal injections as the first response to back pain” rather than trying more conservative (and less costly) treatment first, such as anti-inflammatory meds (ibuprofen), weight loss and physical therapy.

What happened last fall is a tragic reminder to health professionals and patients that every treatment carries a risk, and the best treatment decisions are based on solid scientific evidence of benefit weighed against any potential risks.


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