CDC: Doctors prescribing fewer antibiotics to kids (AP)

ATLANTA � The push to get pediatricians to stop prescribing antibiotics for the wrong illnesses is paying off a bit, a new government report found.

Since the early 1990s, there's been a 10 percent drop in prescription rates for antibiotics for kids 14 and younger, the Centers for Disease Control and Prevention reported Thursday.

Antibiotics are often used � but don't work � against viral illnesses like colds and flu. Antibiotics fight infections caused by bacteria. Misuse can lead to antibiotic resistance.

Experts say doctors inappropriately prescribe antibiotics more than 50 percent of the time, and more often with respiratory infections.

The CDC found larger declines � about 25 percent � in how often doctors used antibiotics against sore throats, colds and some other upper respiratory infections. But there was no significant change in how often they prescribed the drugs for ear infection, bronchitis and sinusitis.

The new findings represent progress, but also suggest that doctors are still prescribing antibiotics too often, said Dr. Lauri Hicks, a CDC epidemiologist who worked on the study.

"The bad news is we still have a long way to go," she said.

The CDC study was the government's first look at the issue in about a decade. It was based on an annual survey of doctors' offices, and compared rates from 1993-1994 to 2007-2008.

The improvement could be partly driven by rapid diagnostic tests that help doctors pinpoint whether a sore throat is caused by a virus or strep bacteria, CDC researchers said. The study also found fewer parents took their kids to doctors for upper respiratory infections, which could be thanks to a vaccine against pneumococcal bacteria that became available in 2000.

A public health campaign about antibiotics may have also had some impact, CDC officials said.

Doctors have not always followed recommendations to cut back on antibiotics, partly because of pressure from parents, said Dr. Kenneth Bromberg, chairman of pediatrics at the Brooklyn Hospital Center in New York.

Moms and dads who have been up with sick, screaming infants in the middle of the night tend to expect more from a doctor than advice to keep an eye on the problem. Often, they want antibiotics, and may not stop at one doctor to get them, he said.

"In this new age of consumerism, they will go somewhere else and get what they want," Bromberg said.

The taxing nature of ear infections may be why the CDC didn't find a decrease in the antibiotic prescribing rate for that problem, he added.

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Online:

CDC report: http://www.cdc.gov/mmwr

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CDC: Half of Americans have a sugary drink daily (AP)

ATLANTA � Health officials say half of Americans drink a soda or sugary beverage each day � and some are downing an awful lot.

A new study found that one in 20 drinks the equivalent of more than four cans of soda each day. The Centers for Disease Control and Prevention research also showed teenage boys drink the most soda, sports drinks and other sugary liquids.

Sweetened drinks have been linked to the U.S. explosion in obesity, and health officials have been urging people to cut back. Many schools have stopped selling soda or artificial juices.

The CDC report released Wednesday is said to be the first to offer national statistics for adults and kids. Past studies have focused on certain groups, particularly school kids.

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Need a C-section? Protection from blood clot urged (AP)

WASHINGTON � New advice for pregnant women: If you're getting a C-section, special inflating boots strapped on your legs may lower the risk of a blood clot.

Hospitals already use these compression devices for other major operations, such as hip replacements, and a growing number have begun offering them for at least some of their cesarean deliveries, too.

Now guidelines for the nation's obstetricians say it's time to make the step routine for most C-sections, which account for nearly a third of U.S. births.

The new recommendations promise to raise awareness of what is a silent threat not just for pregnant women but for thousands of other people, too: Blood clots in veins that can masquerade as simple leg pain.

Called a DVT, for deep vein thrombosis, this kind of clot usually starts in the leg or groin. But it can kill if it moves up to the lungs, where it's called a pulmonary embolism.

These clots make headlines every few years when seemingly healthy people collapse after long airplane flights or similar prolonged inactivity. Certain surgeries also can trigger a DVT. Earlier this year, tennis star Serena Williams was treated for clots in her lungs discovered after foot surgery and cross-country travel.

Obesity, some types of injuries, even some birth control pills can increase the risk, too.

A woman's risk of a DVT jumps during pregnancy and the six weeks afterward. That's partly because of slower blood flow from the weight gain, and because mom is less active in the last trimester and during those first few weeks of recovery from childbirth.

It's also because pregnancy temporarily changes blood to make it clot more easily.

"This is a consequence of nature's protecting women against the bleeding challenges of childbirth," explains Dr. Andra James of Duke University, who co-authored the new guidelines from the American College of Obstetricians and Gynecologists.

Add a C-section and, like any major surgery, it further increases that risk.

As many as two of every 1,000 pregnant women will experience a DVT, James says. Fortunately, pregnancy-related deaths are very rare in this country, but when they happen, those clots are one of the leading reasons.

Yet too few people even know the warning signs, she says: Pain or swelling in one leg, especially the calf or thigh. Redness or warmth in one spot on the leg. If the clot has reached the lung, shortness of breath or chest pain.

The new guidelines urge obstetricians to closely monitor their patients for DVTs � and to check if they have additional factors that would put them at extra risk. Women who've had a DVT earlier in life, or whose close relatives had one � or who have certain inherited clotting disorders � may need anti-clotting medicines throughout the pregnancy, say the recommendations, published in the September issue of the journal Obstetrics & Gynecology.

Then there are those compression devices, which slip over each leg and regularly inflate and deflate, sort of like a massage, to help blood flow more briskly.

The obstetricians' group acknowledges that there haven't been large studies with C-sections to prove how much difference the gadgets could make. But it decided to recommend them anyway because in other types of surgery, the devices can cut the clot risk by two-thirds, James says.

The guidelines recommend strapping them on before the C-section begins, unless there's no time before an emergency operation or the woman is taking anti-clotting medication.

Mount Sinai Medical Center in New York began using the devices for C-sections a few years ago, and deputy chief medical officer Dr. Erin DuPree says they add $14 to the cost of care. Women typically remove and replace them as they ease out of bed throughout the first day after surgery, and no longer need them by the second day, she says.

"It's an easy thing to do that really does not cause harm and could potentially help," she says.

James stresses that leg compression shouldn't lull a woman into thinking she can rest in bed rather than push herself to walk � and a new mom should remain alert to symptoms when she goes home because half of pregnancy-related DVTs occur in those weeks after childbirth.

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EDITOR'S NOTE � Lauran Neergaard covers health and medical issues for The Associated Press.

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Online:

DVT info: http://www.cdc.gov/ncbddd/dvt/index.html

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New HIV case causes LA porn industry shutdown (AP)

LOS ANGELES � A porn industry group says an adult film performer has tested positive for HIV, resulting in a production moratorium in Southern California while the organization investigates to see if the virus has spread.

Free Speech Coalition executive director Diane Duke told The Los Angeles Times ( http://lat.ms/mX0vin) on Monday that her group became aware of the HIV case Saturday.

Duke declined to release the performer's name, age or gender. She also declined to tell the Times how her group learned of the case.

According to Duke, the case was found in an out-of-state clinic that doesn't report to California state officials. Duke says the performer is being retested to confirm the HIV.

The group is working to identify others who had sex with the performer.

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UN warns of bird flu resurgence, new Asian strain (AP)

ROME � The United Nations warned Monday of a possible resurgence of the deadly bird flu virus, saying wild bird migrations had brought it back to previously virus-free countries and that a mutant strain was spreading in Asia.

A mutant strain of H5N1, which can apparently sidestep defenses of existing vaccines, is spreading in China and Vietnam, Tthe U.N. Food and Agriculture Organization said in a statement Monday. It urged greater surveillance to ensure that any outbreaks are contained.

Last week, the World Health Organization reported that a 6-year-old Cambodian girl had died Aug. 14 from bird flu, the eighth person to die from H5N1 avian influenza this year in Cambodia.

Vietnam suspended its springtime poultry vaccination this year, FAO said. Most of the northern and central parts of the country where the virus is endemic have been invaded by the new strain.

Elsewhere, FAO says bird migrations over the past two years have brought H5N1 to countries that had been virus-free for several years, including Israel, the Palestinian territories, Bulgaria, Romania, Nepal and Mongolia.

"Wild birds may introduce the virus, but people's actions in poultry production and marketing spread it," said FAO's chief veterinary office Juan Lubroth in urging greater preparedness and surveillance.

WHO says globally there have been 331 human deaths from 565 confirmed bird flu cases since 2003 when it was first detected.

The virus was eliminated from most of the 63 countries infected at its peak in 2006, but it remained endemic in six countries: Bangladesh, China, Egypt, India, Indonesia and Vietnam.

The number of outbreaks in poultry and wild bird populations shrank from a high of 4000 to 302 in mid-2008, but outbreaks have risen progressively since, with almost 800 cases reported in 2010-2011, FAO said.

"The general departure from the progressive decline in 2004-2008 could mean that there will be a flare-up of H5N1 this fall and winter, with people unexpectedly finding the virus in their backyard," Lubroth said in a statement.

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Taiwan hospital transplants 5 HIV-infected organs (AP)

TAIPEI, Taiwan � One of Taiwan's best regarded hospitals transplanted organs from an HIV carrier into five patients, a hospital official said Monday, in what appears to be one of the most egregious examples of medical negligence in the island's modern history.

The five are now being treated with anti-AIDS drugs, said the official at National Taiwan University Hospital in Taipei.

The official spoke on condition of anonymity because she is not authorized to deal with the media.

In a posting on its website over the weekend, the hospital said the mistake occurred because a transplant staffer believed he heard the English word "non-reactive" on the donor's standard HIV test, which means negative, while the word "reactive" was actually given.

The hospital added that the information on the test result was given over the telephone and was not double-checked, as required by standard operating procedures.

"We deeply apologize for the mistake," the hospital said.

Shih Chung-liang, a Health Department official, said a department team will look into the mistaken transplants and decide on possible penalties for NTUH.

The donor was a 37-year-old man who fell into a coma on Aug. 24 and his heart, liver, lungs and two kidneys were transplanted to five patients on the same day. The heart transplant was conducted at another hospital, while the four other transplants were conducted at NTUH, according to NTUH.

The donor's mother, who was not identified, told cable news stations that she felt terrible about the transplants and had not been aware of her son's ailment. She said he died after "falling from a high spot," without providing details.

Yao Ke-wu, who heads the health department of Hsinchu city, where the donor resided, decried the NTUH transplants as "appalling negligence."

He said NTUH staffers could have avoided the mistake by asking his department about the donor's medical history in advance, and deplored that such inquiries were not mandatory in Taiwan.

Yao said the five organ receivers will very likely contract HIV, and their anti-AIDS treatment will be further complicated because they also have to take medication to modify rejection of the new organs.

There are also concerns among the physicians and nurses who conducted the transplants that they too may contract HIV.

Lee Nan-yao, a physician with the National Chengkung University Hospital, which performed the heart transplant, told the United Daily News that some physicians and nurses who had conducted the transplant "were depressed, and on the verge of panic."

(This version CORRECTS Adds details, byline. Updates with authorities investigating transplants. Corrects how mistake was made.)

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