1. How family doctors can be misled by drug companies An example concerning antibiotic therapy for Upper Respiratory Tract Infections Florence (ITALY) 27 - 30 August 2006 Dr. Guido Giustetto

2. The booklet “Use the best first” Italian family doctors received the revolutionary news: a workshop at The Istituto Superiore di Sanità states that for upper respiratory tract infections – to be effective – to avoid antimicrobial resistence it is necessary to use, from the very beginning, a powerful wide spectrum antibiotic like moxifloxacin.

3. What does literature say ? Literature doesn’t support these theses On the contrary, it advises us to: – Use less antibiotics (the CDC estimates that antibiotic prescribing would be reduced by more than 40%) – Wait before starting therapy – Choose a narrow-spectrum antibiotic, if antibiotic is necessary – Save the new antibiotics for severe conditions

4. What the “real” objective ? To widen the use of moxifloxacin from labelled indications (sinusitis only) to any upper respiratory tract infection To increase the drug sales

5. 3 communication tecnique tricks IData manipulation IIRecourse to a third party IIIUse of a trademark

6. Communication trick No. 1 To distort the picture with: a mixture of correct information and – over-alarming statements – misleading references to tables in the text – deliberately truncated quotations – evocative and allusive words

7. Communication trick No. 2 Recourse to a third party to make the statements more credible and reliable. 40 specialists Paul Erlich (deceased in 1915) Istituto Superiore di Sanità

8. Communication trick No. 3 The logotype has been invented: USE THE BEST FIRST this iconic element strengthens the verbal aspect in favour of a long lasting memorization of the message

9. Conclusion This booklet is not a scientific instrument is a misleading promotion pubblication attempts to interfere with the doctors’ independent and appropriate therapeutic choice goes against the patients’ best interest

10. Conclusion In this booklet marketing comes before science