Antibiotics and sudden death in adults taking renin-angiotensin system blockers
Bibliographic record
Abstract
Is there a cause for concern? Adverse drug reactions have been associated with up to 10% of hospital admissions in older adults,1 a considerable number of which involve drug-drug interactions. Traditionally, information about drug-drug interactions was of poor quality, usually isolated case reports or small uncontrolled case series, resulting in much uncertainty about any clinical relevance. In recent years, large administrative databases that are linkable to health outcomes data have allowed investigators to better quantify rare drug-drug interactions and examine their effect on both morbidity and mortality. In the linked paper (doi:10.1136/bmj.g6196), Fralick and colleagues examined the risk of sudden death in users of both co-trimoxazole and renin-angiotensin system blockers (RASBs), two potassium sparing drugs.2 In an earlier study, the same authors reported that their joint administration was associated with a sevenfold increase in the risk of hyperkalemia induced hospital admission compared with RASB users exposed to other antibiotics.3 The new paper considers this same cohort of older RASB users from Ontario’s administrative databases, but now extends follow-up to 18 years and uses a nested case-control approach. The authors report adjusted odds ratios describing the risk of …
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".