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May 27, 1974

Trends of Antibiotic Use In the United States

Author Affiliations

Norwalk, Conn

JAMA. 1974;228(9):1099. doi:10.1001/jama.1974.03230340014014

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To the Editor.—  As quoted from AMA Drug Evaluations:Sensitivity studies are not usually employed when microscopic examination of a smear indicates that the causative organism is a pneumococcus, meningococcus, gonococcus, treponema, or group A β-hemolytic streptococcus, but they should be made when the organism is a staphylococcus or enterococcus.I admire the talents of whoever wrote this as a microscopist, but the rest of us require cultures rather than smears to identify group A β-hemolytic streptococci and enterococci. Additionally, when staphylococci or pneumococci are present in mixed smears, for example, sputum, they are very difficult to distinguish from other Gram-positive cocci. Proper organism identification is a prerequisite for proper choice of antibiotics.