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

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.

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

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

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

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

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

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

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

Conclusion In this booklet marketing comes before science