Home' Australian Pharmacist : Australian Pharmacist July 2012 Contents 546 Australian Pharmacist July 2012 I ©Pharmaceutical Society of Australia Ltd.
More RCTs with a head to head
comparison of zoledronate and
pamidronate are needed to assess their
overall e cacy in the management of
patients with MM.
The current evidence supports the use
of bisphosphonates in patients with
MM to reduce pathological vertebral
fractures, skeletal related events and
pain. There is no di erence between
the types of bisphosphonates for the
1. Mhaskar R, Redzepovic J,Wheatley K, et al. Bisphosphonates
in multiple myeloma: a network meta-analysis. Cochrane
Database of Systematic Reviews 2012, Issue 5. Art. No.:
2. Tricot G. Multiple myeloma and other plasma cell disorders.
In: Hoffman R, Benz EJ, Shattil SJ, et al. eds. Hematology: Basic
Principles and Practice. 3rd Edition. Philadelphia: Churchill
3. Morgan GJ, Davies FE, Gregory WM. et al. First-line treatment
with zoledronic acid as compared with clodronic acid in
multiple myeloma (MRC Myeloma IX): a randomised controlled
trial. Lancet 2010; 376(9757):1989--99.
4. Djulbegovic B, Wheatley K, Ross J. et al. Bisphosphonates in
multiple myeloma. Cochrane Database of Systematic Reviews
2002, Issue 4.
5. Drake MT, Clarke BL, Khosla S. Bisphosphonates: mechanism
of action and role in clinical practice. Mayo Clinic Proceedings
The Pharmacy Cricket end of season
match between the President's XI
and the Invitation XI at Bowral's
Bradman Oval on Sunday 29 April
was a family affair. Peter Mikhail, a
pharmacist from Elanora Heights
captained the Invitation XI to win the
match and was awarded the Player of
the Season medal.
Wagga pharmacist Justin Smith
playing for the Invitation team topped
scored and retired on 40. His innings
included a six that almost demolished
the scorer's table while his last three
strokes were all fours.
When bowling Justin took three for
ve o two overs. His e orts won him
a well deserved 'Man of the Match'
award which was presented by former
Australian Test Cricket captains,
Ian Craig and Brian Booth. Both are
Pharmacy Cricket patrons.
Playing Pharmacy Cricket for the rst
time Victorian pharmacist Stephen
Speirs and his son Lachlan were
both involved in the dismissal of the
President's XI openers. Lachlan had the
rst caught by his Dad o his bowling.
Stephen bowled the other opener.
A dynamitic duo!
Christo Gove, a pharmacist from
Queensland also playing Pharmacy
Cricket for the rst time distinguished
himself by scoring a duck. Not
knowing what other skills Christo had,
he was given a bowl. Slow left handed
round the wicket.
He started by dismissing the top
scorer for the President's XI, then
went on to take three more wickets
for three, zero and one to nish with
four for 20. What an introduction to
Co-administer vaccines to
reduce deaths in elderly
Administering the pneumococcal
polysaccharide vaccine (PPV23) and the
seasonal in uenza vaccine together
is a potential strategy to increase
pneumococcal immunisation rates, and
prevent hospitalisations and mortality
in elderly people and other high-
This is according to an international
literature review published in the
American Journal of Public Health.
It comprised of nine clinical studies, eight
of which found a concomitant program
with the PPV23 and seasonal in uenza
vaccines conferred clinical bene ts.
Representatives of the In uenza Specialist
Group (ISG), Associate Professor John Litt
and Dr Rod Pearce have supported the
strategy, which is speci cally designed
to reduce the burden of secondary
pneumococcal infections particularly
during seasonal and pandemic
in uenza outbreaks.1 The World Health
Organisation (WHO) also recognises that
PPV23 vaccination may reduce the risk of
severe pneumococcal bacteraemia and
complications in high risk populations
during major in uenza outbreaks.2
Pneumococcal infection causes more
deaths world-wide than any other single
pathogen,3 with more than 75,000
hospitalisations4 and more than 2,300
deaths due to pneumonia and in uenza
in Australia between 2009 and 2010.5
According to Dr Litt, Associate Professor
in General Practice at Flinders University,
GPs should be targeting patients at
high risk of developing pneumococcal
pneumonia this in uenza season and
vaccinating them against pneumococcus.
'It is a very simple strategy to o er the
pneumococcal vaccine at the same time
as the in uenza vaccine. Two key papers
summarised in the Gilchrist review1
clearly show there is a bene t. The most
important thing to note is the NHMRC
Guidelines say the two vaccines can be
PPV23 comprises a mixture of puri ed
capsular polysaccharides from the 23
most prevalent or invasive pneumococcal
types of Streptococcus pneumoniae
(S. pneumoniae). S. pneumoniae can also
cause meningitis, septicaemia, acute otitis
media and sinus infection.6
'Pneumococcus is a very cunning
organism. Antibiotics have been our
mainstay treatment, but we see antibiotic
resistance in 20% of pneumococcal
isolates. On top of that, it is relatively
common. So, how do we stop this?
The best way is to vaccinate,' Dr Litt said.
In Australia, 85--90% of pneumococcal
disease in adults is caused by one
of the 23 serotypes included in the
pneumococcal polysaccharide vaccine.3
Pneumonia-like illness is one of the
top 10 contributing causes of deaths
1. Gilchrist, SAN, Nanni, A. Levine, O. Benefits and effectiveness
of administering pneumococcal polysaccharide vaccine with
seasonal influenza vaccine: an approach for policymakers. Am.
J. Public Health. April 2012;102(4):596--605.
2. World Health Organization. 23-valent pneumococcal
polysaccharide vaccine. WHO position paper. Wkly Epidemiol
3. Forrest JM, McIntyre PB, Burgess MA. Pneumococcal disease in
Australia. Commun Dis Intell 2000;24:89--92.
4. AIHW National Hospital Morbidity Database. Separation
statistics by principal diagnosis in ICD-10-AM, Australia,
2008--09 to 2009--10.
5. ABS Causes of Death Australia 2010. Released March 20, 2012.
6. Pneumovax 23 Product Information, 2011.
7. AIHW 2010. Australia's health 2010. Australia's health no. 12. Cat.
no. AUS 122. Canberra: AIHW.
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