Fluoroquinolones Prescribed Too Frequently
In contradiction to evidence based recommendations, fluoroquinolones are prescribed far too often for uncomplicated urinary tract infections. This has serious and negative effects on the epidemiological situation for such infections.
The reason for this behavior on the part of doctors may be the free samples distributed by pharmaceutical companies. This accounts for many fluoroquinolones having been brought into circulation in Germany in recent years. It has been proved that distributed samples, notwithstanding their good and non-suspicious reputation (even with critical physicians), result in inappropriate prescriptions (1). Even the argument that samples constitute support for patients who are financially less well-off cannot be proved (2).
“Good common sense” enables further analysis: why would the pharmaceutical industry deliver social work? Manufacturers should, and must, sell. In order to improve sales, samples are handed out as enticements. Doctors are not obliged to support this sales strategy. The argument that samples may contribute to therapeutic experiences pales into insignificance in view of two permitted N1-packs per drug and per year. However, other insights may be gleaned: samples lead to a better presence in the market, even if guidelines advise against their use.
Conflict of interest statement
The author has received honoraria for speaking from the Rosa Luxemburg Foundation. He sits on the board of MEZIS e.V. (“Mein Essen zahl ich selbst [I pay for my own meals]”).
|1.||Adair RF, Holmgren R: Do drug samples influence resident prescribing behavior? A randomized trial. Am J Med 2005; 118: 881–4 CrossRef MEDLINE|
|2.||Cutrona SL, et al.: Free drug samples in the United States, characteristics of pediatric recipients and safety concerns. Pediatrics 2008; 122: 736–42 CrossRef MEDLINE|
|3.||Velasco E, Noll I, Espelage W, Ziegelmann A, Krause G, Eckmanns T: A survey of outpatient antibiotic prescribing for cystitis. Dtsch Arztebl Int 2012; 109(50): 878–84. VOLLTEXT|