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Diagnosis and Treatment |

Use of Antibiotics: A Brief Exposition of the Problem and Some Tentative Solutions

CALVIN M. KUNIN, M.D., F.A.C.P.; THELMA TUPASI, M.D.; and WILLIAM A. CRAIG, M.D.
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The study performed by Dr. Tupasi was conducted under a grant from the Rockefeller Foundation while she was a fellow in infectious disease at the University of Virginia School of Medicine.

▸Requests for reprints should be addressed to Calvin M. Kunin, M.D., Veterans Administration Hospital, 2500 Overlook Terrace, Madison, WI 53705.


Madison, Wisconsin


Ann Intern Med. 1973;79(4):555-560. doi:10.7326/0003-4819-79-4-555
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Antibiotics are overused in this country. Concern about the problem has been expressed by a Senate investigating committee, the Food and Drug Administration, and by many authorities in the field. Inappropriate use in office practice is common. This is both wasteful and associated with a high frequency of undesirable reactions. Studies in hospitals show that more than half the antibiotics used are not needed, or that an inappropriate agent is chosen, or the dose is incorrect. Antibiotics accounted for 19% to 34% of the pharmacy budgets in three representative hospitals in Madison, Wisconsin. Cephalosporins and aminoglycosides (mostly gentamicin) accounted for 69% of all hospital antibiotic costs. The use of cephalexin, a drug whose cost to the hospital almost equaled all other oral antibiotics combined, has been successfully controlled. Usage of the most expensive agents in hospitals should be controlled. Training in clinical pharmacology should be emphasized throughout the medical school curriculum.

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