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September NaN, 1999

Making Doctors

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;282(12):1134. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-12-jbk0922

To the Editor: The medical community should be aware of a pharmaceutical marketing practice that creates pressure on hospital pharmacies to distort incentives and recommendations regarding antimicrobial use from those arising exclusively from efficacy, toxicity, and single drug cost-effectiveness considerations. There are important counterforces to these pressures—medical education, practice standards, the hospital's pharmacy and therapeutics committee, clinician integrity—but loss of prescriber confidence in pharmacy recommendations can have damaging consequences. Among these is undermining programs to decrease overall antimicrobial use designed to delay the spread of antimicrobial resistance.

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