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The majority of patients care calls referred to practitioners at each of two family practice office study sites were related to medications. However, there were significant differences in the proportion of patient care calls managed by staff physicians, family practice residents, and clinical pharmacists which involved discussion of medication. There were also significant differences in the callers and types of medication related calls managed by each practitioner group. Calls initiated by patients and those classified as refill requests accounted for the largest proportion of calls managed by staff physicians, residents, and clinical pharmacists. The majority of calls received by each practitioner group were managed without consultation. A follow-up office visit was recommended in approximately one half of all medication related calls. The findings of this study may be useful in determining the personnel required to manage medication related telephone calls and in identifying potential areas for education and training of personnel in family practice.

Nasal swabs were obtained from 408 patients seen in a family practice office in an attempt to identify Staphylococcus aureus carriers. Isolated strains were tested for sensitivity to 11 antibiotics. Study participants were interviewed to obtain the following data: age, history of recent hospitalization and/or recent antibiotic use, number of household members, and occupation, if employed in a health-care facility. S aureus was isolated from 109 nasal swabs. This represents a 26.7 percent carrier rate. Only 25.7 percent of the isolates were sensitive to penicillin G and ampicillin. No statistically significant association was found between the patient variables and either the carrier rate or the sensitivity of the S aureus isolates to penicillin. The sensitivity testing demonstrated that 94.5 percent of the isolates were sensitive to tetracycline and erythromycin. Ninety-nine to 100 percent of the isolates were sensitive to all other antibiotics tested. The authors conclude that penicillin G should not be used in the treatment of S aureus infections. Erythromycin, due to demonstrated sensitivity and reasonable cost, is recommended for mild to moderate infections.

The objective of this study was to examine differences in prescribing characteristics among four Iowa family practice offices, each associated with family practice residency programs. This prospective study collected data over a four-month period, utilizing duplicate, carbon-copy prescriptions. The prescriptions were tabulated according to individual drug and therapeutic categories. Differences in prescribing frequency among offices were analyzed using chi-square 2 X 2 contingency tables. The number of prescriptions written at each office (designated A through D) were as follows: A, 1,034; B, 1,449; C, 2,965; and D, 2,335. The most frequently prescribed drug category was systemic antibiotics, followed by cough, cold, or allergy products, analgesic and anti-inflammatory drugs or muscle relaxants, diuretics, and topical anti-infectives. There were statistically significant differences in the frequencies of these categories among offices. The most frequently prescribed drug was amoxicillin at offices A, B, and C, and erythromycin at office D. There were statistically significant differences in the frequencies of the top ten drugs at each office. From these data the family practice faculty and clinical pharmacists can identify therapeutic areas that may require additional educational emphasis for the resident.