Let's start with something interesting. There is a direct relationship between the insistence of the patient or his companion and the formulation of antibiotics. Among these, the antiparasitic drugs. In fact, many emergency departments have unwritten protocols for an antibiotic formulation based on reassessments.
Normally doctors are asked to deworm the kids.
Pediatricians are usually the most careful when it comes to drugs formulation, but here is something they may not consider, even when they occasionally recommend it as part of their formulation. Smectite clays.
Smectite (diosmectite) is a type of magnesium silicate. I once wrote about another type of silicate, asbestos. There are multiple physical and chemical differences between the two but both have carcinogenic risks comparable if lung exposure occurs. However, it is not common to consume Smecta through the lungs and even in the case of asbestos, years of exposure might be necessary.
For centuries medicinal clays have been used, especially the smectite type because of its antitoxic properties.
One of the great problems of food, when there is food in multiple African countries and some regions of my country, Colombia, is the exposure to mycotoxins and aflatoxins in common food
Aflatoxins have been shown to be correlated with breast cancer, increased viral load in chronic viral infections and other beauties. It is associated with prolonged diarrhea, intestinal malabsorption, protein malnutrition, strongly to cellular hepatocarcinoma a rare disease (2 / 100,000 inhabitants, remember is all less than 5 / 100,000 or almost 4.5 standard deviations in prevalence). 1
In the developed world there are protocols for treatment of the land to avoid such problems, particularly for feeding animals2.
Smectite silicates have problems and benefits.
- They increase the absorption of calcium (Terramine used by the NASA as the supplement of calcium in astronauts, superior absolutely to everything) a
- They adhere to heavy metals and prevent their absorption (Bentonite tablets were used since the 17th century to counter poisoning arsenic and mercury between the English oligarchy) b
- Perhaps the only oral and topical antitoxic/antitoxin, without interesting fungal or bacterial resistance mechanisms (since its action is mechanical and chemical) c
- They increase the time of absorption and decrease the bioavailability of multiple medications, (especially important in patients consuming antiarrhythmic and coumarins) b
- They decrease the absorption of iron and zinc during prolonged periods (Especially important in pregnant women)
+/- Constipation. b
Interestingly in children has been seen has an NNT of 1: 12.5 to cut diarrhea of more than 7 days as an adjuvant along with oral rehydration. It is good since it is a relatively low dose. Symptomatically decreases the frequency and intensity by for 50%. Even so, his recommendation is not usually given the "poor evidence." Or rather, their lack of cost-effectiveness studies. 3
Although a kilo of calcium bentonite costs ( USD 0.7) 2,000 COP ...
Sometimes capitalism you are a bitch and I would like to hit you, then I remember that there are worse things and that you have no body.
In Africa, it is used as an "antiparasitic" in addition to the management of acute and subacute diarrhea. 0.7-1.5g / kg / day for 10-14 days every 6 months. Its main effect is the increase in height in children compared to controls. Its mechanism is the reduction of aflatoxins especially accumulated in flours, evidenced by a urinary decrease of the AFB1G, that alter the liver function diminishing the protein production (deficiency of vitamin k, clotting factors, albumin) and as therapy for chronic poisonings by heavy metals in water. 4
One that must be careful with smectic because it can cause problems. It is also a useful medicine outside the usual field of observation in medicine. A cost-effective intervention, of the few useful interventions, forgotten and treated without rigor. Certainly better than giving other antibiotics because they came for reassessment.
Interactions of Aflatoxin B1 with Smectites: Interlayer Accessibility, Bonding Mechanisms, and Size Matching
German Cano-Sancho, Sonia Marin, Antonio J. Ramos, Juan Peris-Vicente and Vicente Sanchis; Occurrence of aflatoxin M1 and exposure assessment in Catalonia (Spain). Rev Iberoam Micol. 2010;27(3):130–135
Bonding mechanisms between aflatoxin B1 and smectite; YoujunDenga. . Ana Luisa BarrientosVelázqueza. FerencBillesb. Joe B.Dixona. Applied Clay Science Volume 50, Issue 1, September 2010, Pages 92-98
Guarino A1, Bisceglia M, Castellucci G, Iacono G, Casali LG, Bruzzese E, Musetta A, Greco L; Italian Society of Pediatric Gastroenterology and Hepatology Study Group for Smectite in Acute DiarrheaSmectite in the treatment of acute diarrhea: a nationwide randomized controlled study of the Italian Society of Pediatric Gastroenterology and Hepatology (SIGEP) in collaboration with primary care pediatricians. SIGEP Study Group for Smectite in Acute Diarrhea.
. J Pediatr Gastroenterol Nutr. 2001 Jan;32(1):71-5.Deng, Y., L. Liu, A. L. Barrientos Velázquez, M. Szczerba, J. B. Dixon 2014. Interactions of Aflatoxin B1 with Smectites: Interlayer Accessibility, Bonding Mechanisms, and Size Matching. In: J. B. Dixon, A. L. Barrientos Velázquez, Y. Deng, editors, Aflatoxin Control: Safeguarding Animal Feed with Calcium Smectite, ASA and SSSA, Madison, WI. p. 27-43. doi:10.2136/2014.aflatoxins.c4