Recalls of generic drugs raise safety concerns

This issue also includes stories on antibiotic stewardship and point-of-care ultrasound, as well as conference coverage from the American Public Health Association and CHEST.

Those keeping an eye on FDA news have no doubt spotted the string of reports recalling generic drugs, most commonly angiotensin-receptor blockers, due to concerns about impurities, specifically the possible presence of carcinogens. This trend has raised understandable worries about how to balance the importance and value of generics with concerns over manufacturing quality and effectiveness of therapy, but while the situation bears watching, most experts agree that generics remain overwhelmingly safe. Our cover story in this issue reviews the scope of the problem and the implications of generic recalls for primary care physicians.

In other drug news, the CDC reports that 48,700 patients in the U.S. now die of antibiotic resistance or Clostridioides difficile infection each year, versus about 37,000 in 2013. As part of an effort to combat this worsening problem, The Joint Commission has put new antibiotic stewardship requirements in place for outpatient practices, similar to those instituted for accredited hospitals in 2017. The requirements, which go into effect this month, apply only to currently accredited ambulatory care practices but could have ripple effects for raising awareness about and addressing this issue. Our second cover story discusses The Joint Commission's requirements as well as what outpatient practices are already doing to help take on this growing threat.

Point-of-care ultrasound (POCUS) has become much more common over the past several years, and as the technology improves and becomes more portable, its popularity in medicine, including primary care, continue to increase. Our story takes a closer look at this imaging tool and includes experts' opinions about its pros and cons, as well as the need for proper training for those who opt to use it.

Our conference coverage in this issue is from the American Public Health Association's 2019 annual meeting, held in November in Philadelphia, and CHEST 2019, held in New Orleans in October. Sessions at the former looked at improving nutrition education among physicians and medical students and follow-up of abnormal test results among patients. In addition, a story looks at efforts in Philadelphia to establish the nation's first legal safe injection site in an effort to reduce overdose deaths. Meanwhile, a story from CHEST 2019 provides an overview of therapy for latent tuberculosis infection, including an update on the latest regimens and tips and tools to improve patient adherence.

All of us at ACP Internist wish our readers a very happy new year and look forward to covering new developments in health care in 2020. If there's anything in particular you'd like to read about this year, please let us know at We love to hear from you!


Jennifer Kearney-Strouse
Executive Editor, ACP Internist