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Prescribing of Chloramphenicol in Ambulatory Practice: An Epidemiologic Study Among Tennessee Medicaid Recipients

WAYNE A. RAY, M.S.; CHARLES F. FEDERSPIEL, Ph.D.; and WILLIAM SCHAFFNER, M.D., F.A.C.P.
[+] Article and Author Information

Grant support: in part by Tennessee Contract FA 1793, and U.S. Public Health Service Grants No. AI 03082, HS-00037, HS-00965, and HS-01703.

▸Requests for reprints should be addressed to Wayne A. Ray, Division of Biostatistics, Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232.


Nashville, Tennessee


Ann Intern Med. 1976;84(3):266-270. doi:10.7326/0003-4819-84-3-266
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During the 1-year period from July 1973 through June 1974, 1761 chloramphenicol prescriptions were written for 992 outpatients in the Tennessee Medicaid program. Six percent (205 of 3409) of participating physicians prescribed chloramphenicol; 20 physicians wrote 55% of the prescriptions. Both family practice and rural location were independently associated with increased rates of prescribing chloramphenicol for outpatients. Among rural family practitioners, 21% prescribed chloramphenicol. Physicians graduating since 1955 were as likely to have prescribed chloramphenicol as were earlier graduates. Almost half the adult patients received 6 grams or less, while 2 received more than 250 grams. Approximately half of the prescriptions were for treatment of upper respiratory infections. Most prescriptions were interdicted by good medical practice. Analysis of the prescribing of chloramphenicol (and perhaps other drugs) in ambulatory practice will help identify those physicians most in need of remedial medical education.

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