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To the Editor.—
The article by Shapiro et al, "Benefit-Cost Analysis of Antimicrobial Prophylaxis in Abdominal and Vaginal Hysterectomy" (1983;249:1290), was funded by the manufacturer of a drug known as cefazolin sodium and concluded that short courses of this particular substance given prophylactically would be useful in reducing hospital costs. The reported article is potentially defective in regard to the definition of "morbidity." The extraordinarily high morbidity that was described for patients who had had a hysterectomy must have been the result of the definition. Greater than 40% of the patients who had had a hysterectomy included in the study were said to have morbidity. The fact that a fever of two days' duration would be considered morbidity for the purposes of the study was probably the cause of the unusually high stated morbidity. I would suggest that a manufacturer of acetaminophen support a similar study to determine whether its
Schonberg SE. Cost of Antibiotics. JAMA. 1983;250(13):1693–1694. doi:10.1001/jama.1983.03340130023012
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