Characteristics and attitudes of physicians associated with the prescribing of chloramphenicol.

Three of the authors are with Johns Hopkins University. Dr. Becker is assistant professor in the departments of pediatrics, behavioral sciences, and social relations. Dr. Stolley is associate professor, and Mrs. Sloane is research assistant in the department of medical care and hospitals. Dr. Lasagna is professor and chairman, department of pharmacology and toxicology, University of Rochester. Dr. McEvilla is professor, department of pharmaceutical economics, University of Pittsburgh. This study was supported by the Public Health Service in the following manner: Contract No. HSM 110 69 234 and by grants 8 RO] HSOOIIO, 8 TO] HSOOO12 and 5 R18 HS00237-02 from the National Center for Health Services Research and Development and by grant 5 D04 AH 00076 from the National Institutes of Health. Tearsheet requests to Dr. Marshall H. Becker, Johns Hopkins Hospital, 601 N. Broadway, Baltimore, Md. 21205. DRUG THERAPY is a critical component in the health professional's armamentarium and an undisputed contributor to man's well-being in the prevention, control, and treatment of disease. Unfortunately, drug therapy also provides risk of inappropriate prescribing, dispensing, administration, and ingestion of drugs, as well as of toxic effects from medications prescribed correctly or incorrectly. These facts comprise a public health problem of increasing concern to the general public and to the health professions. In particular, problems resulting from what Brodie (1) has termed "the apparent irresponsible prescribing habits of many physicians" must be examined as an important part of the evaluation of the quality of medical practice (2). Perhaps the least serious problem is errors in prescribing which result in the consumption of drugs merely ineffective in ameliorating the conditions for which they are used. Brodie (la) has estimated such "drug waste" at about 25 percent of all drug therapy, costing between $1 billion and $2 billion annually. Data on adverse drug reactions, however, clearly depict the more harmful