St. John's Wort for Depression

St. John's wort is safe and effective for short-term (six to eight weeks) relief of mild to moderate depression in adults. [Strength of recommendation: A, based on consistent evidence from high-quality systematic reviews

Antiepileptic Drug Level Monitoring

Routine monitoring of antiepileptic drug levels does not alter seizure or side effect rates. (Strength of Recommendation [SOR]: B, based on a single randomized controlled trial [RCT] with less than 80 percent follow-up). Antiepileptic drug level monitoring may be clinically useful in special populations, including patients with suspected drug toxicity or noncompliance, pregnant patients, and patients with renal failure. Monitoring dosage increases of drugs with nonlinear kinetics, such as phenytoin (Dilantin), may be useful. (SOR: C, based on expert opinion). Therapeutic drug level monitoring of newer antiepileptic drugs has not been shown to be clinically useful. (SOR: C, based on expert opinion)

What regimens eradicate Heliobacter pylori?

Fourteen-day triple therapy with a proton pump inhibitor (PPI) plus clarithromycin and either amoxicillin or metronidazole is superior to 7-day therapy in eradicating Heliobacter pylori (strength of recommendation [SOR]: A, highquality meta-analysis). Seven-day triple therapy with a PPI or ranitidine bismuth citrate plus clarithromycin and either amoxicillin or metronidazole is also effective (SOR: A, high-quality systematic review). Three-day quadruple therapy with a combination of PPI, clarithromycin, bismuth subcitrate, and metronidazole or a combination of PPI, clarithromycin, amoxicillin, and metronidazole also appears to be effective (SOR: B, unblinded randomized controlled trial)

Is the long-term use of proton pump inhibitors safe?

Long-term use of proton pump inhibitors (PPIs) appears safe, resulting in no clinically relevant adverse effects (strength of recommendation: B, based on nonsystematic reviews, cohort studies, or low-quality randomized controlled trials). No evidence clearly links PPIs to gastric cancer or carcinoid, enteric infections, or significant nutrient malabsorption