Antibiotika 1999

The Glitze Pharmaceuticals rep entered my office at the appointed hour and greeted me with a triumphant smile.
Rep.: „Dr. Lettau, I appreciate this opportunity to present our next sixth generation cephalosporin, Cefaholygrail. Its spectrum of activity is not just broad, it’s universal. It covers all gram positives including resistant staph and enterococcus, all gram negatives including pseudomonas, all anaerobes, and even chlamydia and rickettsia.“
Dr.: „I’ll bet that coverage includes the flora inhabiting the lower backside of the prescriber. Hmmm, includes rickettsia you say - you mean I can now finally sleep better at night, not tossing and turning over whether Tsutsugamuchi fever was covered?“
Rep.: „I guarantee it. In fact, if you get called in the middle of the night about a fever, you could prescribe it while half-asleep because it covers everything.“
Dr.: „Is it approved for FAOs?“
Rep.: „What’s that?“
Dr.: „Fevers of any origin.“
Rep.: Yes, FDA approved. And we are convinced this drug is the most rational and appropriate choice for empiric therapy of any suspected bacterial infection.“
Dr.: „What was the name of your drug again?“
Rep.: „Cefaholygrail.“
Dr.: „Finally a cephalosporin whose name isn’t a hypnotic mind-boggling permutation of c,f,t,z, and x. How did they let you name it without at least having the letter z or x in it?“
Rep.: „They didn’t. The generic name is cefaglitzemax.“
Dr.: „I see. I would guess the cost of the drug must be to the max too. I mean in a real budgetbuster class.“
Rep.: „Well it’s a buck a gram cheaper than the other universal-spectrum antibiotic on the market.“
Dr.: „You mean Nukacycline? That costs 500 dollars a gram!“
Rep.: „But you have to admit that ours would be cost saving in comparison. Besides, think of all the money saved by eliminating cultures and sensitivities. And your pharmacy would hardly have to stock any other antibiotics.“
Dr.: „So what’s the evidence that it works in patients?“
Rep.: „Here, I brought you a copy of this special symposium on Cefaholygrail published in a supplement of the International Archives of Rational and Appropriate Antibiotic Use.“
Dr.: „Thanks. Hmmm, I see here it does as well as penicillin for strep throats. I wish you would have compared your drug to Nukacycline or that new quinolone, Panfloxacin. Hey, wait a minute! In one study 30% of patients treated with Cefaholygrail died of fungemic superinfection!“
Rep.: „We know that, but our company is about to release our new universal-spectrum antifungal, Omnitericin-Z. We expect that combination therapy with Cefaholygrail will be the first regimen to sterilize a patient.“
Dr.: „If that happens, I suppose you’ll be looking to use them for surgical prophylaxis.“
Rep.: „Sure, why not?“
Dr.: „You know, I believe what Louis Pasteur said about 100 years ago: ‘The microbes will always have the last word.’“
Rep.: „We don’t believe it.“
Dr.: „Good-bye, Madam. I’ll pass on the Holy Grail replica penlight.“
Rep.: „Good-bye, Dr. Lettau. Thanks for your time.“

Lettau, L.A. Antibiotics 1999; Ann Intern Med 1989; 110:850 [gekürzt]





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