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May 25, 1994

Pharmacy Practice and Antibiotic-Resistant Tuberculosis Along the US-Mexico Border

Author Affiliations

Project HOPE Millwood, Va
Fairfax, Va

JAMA. 1994;271(20):1577-1578. doi:10.1001/jama.1994.03510440037027

To the Editor.  —Multiply-resistant tuberculosis is increasing in the United States and is emerging as a significant public health problem.1 Contributing to this is opportunistic infection of those immunocompromised with human immunodeficiency virus2,3 and possible indiscriminate or inappropriate use of therapeutic agents.4Inappropriate use may be promoted by the discrepant regulation of drugs along the US-Mexico border. Health professionals are aware that Mexican and American consumers are frequenting pharmacies on the Mexican side of the border to obtain drugs that commonly can be purchased without a prescription and often at lower cost than in the United States. The density of pharmacies in many Mexican border towns exceeds possible demand for pharmacy services from the local population and appears to serve transient consumers crossing the border. In May 1993, a nurse practicing in the US city of Nogales, Ariz, encountered a mother who was treating her child for

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