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This profile was last updated on 4/8/07  and contains information from public web pages.
 
Background

Employment History

Education

  • MD
  • medical degree
    University of Pennsylvania
  • bachelor of arts , Biological Sciences
    University of Rochester
  • master's degree , Epidemiology
    University of Ottawa
  • Bachelor of Arts degree , Biological Sciences
    University of Rochester
  • M.D.
35 Total References
Web References
... that the H5N1 wild bird ...
www.matchpot.com, 8 April 2007 [cached]
... that the H5N1 wild bird flu sequences are a poor match for the pandemic vaccine as are human cases in ... ... Last week, Joe Howton, medical director at the Adventist Medical Center in Portland, Oregon, suggested ... http://birdfluwatch.co.uk/
Poultry and Bird Flu News
www.poultrymed.com [cached]
Last week, Joe Howton, medical director at the Adventist Medical Center in Portland, Oregon, suggested a way to double supplies, after browsing basic safety data from Roche for a talk on avian influenza.The technique was invented during the Second World War to extend precious penicillin supplies.Scientists found that a simple benzoic acid derivative called probenecid stops many drugs, including antibiotics, being removed from the blood by the kidneys.Probenecid is readily available and is still widely used alongside antibiotics to treat gonorrhoea and syphilis, and in emergency rooms, where doctors need their patients to have high, sustained levels of antibiotics in their blood.
Howton noticed from Roche's data that Tamiflu, like penicillin, is actively secreted by the kidneys, and that the process is inhibited by probenecid.Giving the flu drug together with probenecid doubles the time that Tamiflu's active ingredient stays in the blood, doubles its maximum blood concentration, and multiplies 2.5-fold the patient's total exposure to the drug (see graph, and G. Hill et al. Drug Metab.Dispos.30, 13-19; 2002).In other words, you could get away with using half as much Tamiflu to get the same therapeutic effect."It dawned on me that the data potentially represented a tremendous therapeutic benefit," Howton told Nature.
Healthcare Sales & Marketing Network News: ER Physician Suggests Potential Method to Double Anti-flu Medicine Supply
www.salesandmarketingnetwork.com, 8 Nov 2005 [cached]
EMERYVILLE, Calif.--(HSMN NewsFeed)--Nov. 8, 2005--ER Physician, Joseph Howton, MD, supports the use of Tamiflu, an anti-flu drug, with Probenecid, an acid derivative that sustains medicine in the system, as a method of doubling the available supply of Tamiflu to combat a flu pandemic.
In the November issue of the journal, Nature, Dr. Howton explains how he came to this conclusion. i(i) While reviewing data on Tamiflu by Swiss drug maker, Roche, he realized that Probenecid would help inhibit Tamiflu from being secreted by the kidneys, causing the drug to remain in the body longer.According to the article, this technique is similar to methods used during WWII to extend the penicillin supply in a time of major shortages of antibiotics.
Tamiflu attacks the influenza virus and stops it from spreading inside the body. ii(ii) Nature explains that in the past, Probenecid was commonly used in the emergency department as it allows for high, sustained levels of antibiotics in the bloodstream.Dr. Howton told the Australian Broadcasting Corporation (ABC) that Probenecid allows Tamiflu to recirculate and "...you have better virus-killing effect."iii(iii) He adds that the combination can be used in two ways.The first method would be to administer a half-dose or less of Tamiflu along with Probenecid, which would produce "roughly the same levels as if we had just given a full dose," and would "...treat twice as many people with the same amount of drug."Another approach described by Dr. Howton would involve a standard dose of Tamiflu with Probenecid, to "...produce a higher than usual tissue level of Tamiflu," which, he explains "...might actually be necessary for optimal effectiveness."
Although the Tamiflu and Probenecid strategy has been previously researched, Dr. Howton's recent comments have helped revitalize interest in this treatment method.Prentice Tom, MD, Chief Medical Officer for California Emergency Physicians Medical Group (CEP), speculates, "Dr.Howton's comments may even contribute to a change in how we treat the flu worldwide."
Still, in his quote to ABC, Dr. Howton warns the discovery is not an answer to a potential bird flu pandemic."The only way we're going to prevent massive numbers of fatalities in the event of a major pandemic is by a vaccine," he explains."The whole idea of a drug like Tamiflu is to buy us time, so that the vaccine can be developed."
Joseph Howton, MD, is Medical Director at Adventist Medical Center in Portland and a Partner of Willamette Emergency Physicians, an affiliate of California Emergency Physicians Medical Group (CEP).
Last week, Joe Howton, ...
www.kathryncramer.com [cached]
Last week, Joe Howton, medical director at the Adventist Medical Center in Portland, Oregon, suggested a way to double supplies, after browsing basic safety data from Roche for a talk on avian flu.
...
Last week, Joe Howton, medical director at the Adventist Medical Center in Portland, Oregon, suggested a way to double supplies, after browsing basic safety data from Roche for a talk on avian flu.
The Agonist | thoughtful, global, timely
agonist.org [cached]
Joe Howton, a medical director at the Adventist Medical Center in Portland, Oregon believes probenecid, a treatment for gout which is used with some antibiotics to boost effectiveness, could have a similar impact with Tamiflu.
No one knows how effective the drug will be against a pandemic strain but it is considered the best option until a vaccine can be developed.
Howton was browsing through safety data published by the drug's Swiss manufacturer Roche when he noticed that giving Tamiflu with probenecid doubles the number of hours its active ingredient is in the blood.
Probenecid works by preventing the drugs from being removed from the body by the kidneys.
"It dawned on me that the data potentially represented a tremendous therapeutic benefit," he told the science journal Nature.
If he is right, half a dose of Tamiflu with probenecid would be as effective as a full dose without it.
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