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Antibiotic eases common stomach pain, studies find


4 Star


Antibiotic eases common stomach pain, studies find

Our Review Summary

AP included cost information, and this is a significant factor that should not have been ignored by other stories.

At the same time, the lack of independent experts was a flaw. This is underscored by an unrepresentative anecdote from a glowing patient success story, even though the study itself showed that the vast majority of people did not get adequate relief. And the placebo effect alone was  significant.


Why This Matters

Because IBS treatment has been a frustrating experience for so many, even a modest improvement in symptoms that lasts a few months may be worthwhile for some. This appears to be a novel way of treating IBS, and the fact that symptoms improved at all is of interest, even if the duration of the study was short. At $21 a pill, though, one could ask hard questions about how many people are actually going to benefit and whether the treatment is a cost-effective alternative.


Does the story adequately discuss the costs of the intervention?


Hooray! Unlike the WebMD story, this story includes cost information. “The price for IBS treatment hasn’t been determined, he said. But the price listed at suggests it’s not cheap, with a two-week supply of the dosage used in the study costing $910, or about $21 a pill.” By providing the price and actually showing readers (and other reporters) the source for the price, the story puts the antibiotic treatment into perspective and goes part of the way toward helping readers judge how cost-effective this treatment may be.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?


Unlike the WebMD story, which took too long to present any of the data, this story attempts to quantify the benefits in the second sentence. “In two large studies, 41 percent of the patients who took the antibiotic rifaximin said their symptoms substantially improved, compared to 32 percent of those who got fake pills. Their relief lasted for up to 10 weeks.”

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The story makes no mention of harms other than antibiotic resistance. Instead, the story says the drug “also been safely used elsewhere for more than two decades.” But readers should be told explicitly what side effects were found in the study.

Does the story seem to grasp the quality of the evidence?


The story adequately addresses the number of patients studied, the duration of study and the study endpoints.

Does the story commit disease-mongering?


The story does not engage in disease-mongering. It says that IBS is “a poorly understood and painful condition that especially afflicts younger women” and says that IBS affect as many as 1 in 5 Americans.”  Better than the WebMD story on this count as well, AP explains that the non-constipation form of IBS is “the most common form.”

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

The only researchers quoted in the story are researchers who do drug-company-funded research on IBS drugs. The lead author is identified this way: “Dr. Mark Pimentel, of Cedars-Sinai Medical Center in Los Angeles,” and only much later does it say, “The studies were paid for by the Salix, based in Raleigh, N.C. Some of the researchers were Salix employees and others had received consulting and other fees from the company. Cedars-Sinai holds a patent on the use of rifaximin for irritable bowel syndrome.” The story should have said clearly, as the WebMD story did, that Pimentel serves as a Salix consultant and sits on its scientific advisory board. The story also quotes Dr. Jan Tack, “of the University of Leuven in Belgium.” It makes no mention of the detail noted in the WebMD story: that Tack has worked as a scientific advisor to companies evaluating IBS treatments. The final quarter of the story is devoted to Amy McMahon, “who developed the disorder about four years ago.” It says, “She tried a variety of treatments, changed her diet, and saw a number of specialists before Pimentel prescribed the antibiotic about a year later. “I felt remarkably better” after one treatment, said McMahon.

So here you have a drug-company funded researcher providing a success-story-patient for a quote. The story could have included other patients who saw no relief or no patients at all. This skews the entire perspective of the story. A more representative picture would have been presented by including one of the vast majority who saw no improvement from the antibiotic.

Does the story compare the new approach with existing alternatives?


Slightly better than the WebMD story.  It says, “What causes the disorder has been a mystery; sensitivity to certain foods or stress are among the theories. Patients are typically told to change their diet, reduce stress and take medicines or fiber supplements to ease symptoms.” There is no quantitative statement about relative effectiveness of the existing approaches, but they are mentioned and it is clear that symptom reduction is the best that can be offered.

Does the story establish the availability of the treatment/test/product/procedure?


The story explains that: “In the U.S., rifaximin is approved for traveler’s diarrhea and for a complication of liver disease. Salix Pharmaceuticals, which markets rifaximin under the name Xifaxan in the U.S., is seeking to expand its use to IBS. A decision from the Food and Drug Administration is expected in March, said William Forbes, executive vice president and chief development officer for Salix.”  Taking predictions from a company exec about when the FDA might act would not result in a good batting average over time.

Does the story establish the true novelty of the approach?


This story, at least, quoted the author of an accompanying editorial saying that he thought the treatment was novel.

Does the story appear to rely solely or largely on a news release?


The story does not rely on a news release.

Total Score: 8 of 10 Satisfactory


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