BACITRACIN
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Here's a good one:

Smack, DP, Harrington AC et al., Infection and allergy incidence in
ambulatory surgery patients using white petrolatum vs Bacitracin ointment,
JAMA; 1996:276(12):972-977.

The take home lessons: Bacitracin ointment and white petrolatum have about
the same effect on healing wounds. There is a slight increase in infection
with staph aureus in the petrolatum group and a slight increase in gram
negative infection in the bacitracin group. The infection rate in the
white pet group was 2% and in the bacitracin group was 0.9% but the cost
to treat the infections was much higher in the bacitracin group since
Cipro was used for the gram negative organisms.

The authors state: "We estimate a switch from antibacterial ointments to
white petrolatum by US dermatologists would result in health care cost
savings of $8 million to $10 million annually nationwide. If a similar
switch were adopted by primary care, surgical, and surgical subspecialty
physicians, the resultant savings could be on the order of hundreds of
millions of dollars annually nationwide."

Haines Ely
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Before I condemn this article as the worst sort of statistic-driven penny
pinching that saves money on paper but not in the real world, and as the sort
of MBA term paper pseudoscience that passes for progress,  and as part of the
HMO-abetting trend to revert to "do nothing" medicine; I would like to
apologise to any friends/acquaintances who might be hidden in the "et al" of
the reference.

Actually, I agree with you up to a point. Challenging assumptions is great,
especially in areas of medical importance such as hypertension therapy etc.
Its just hard for me to believe that that many $$ or lives will be saved by
avoiding a dab of antimicrobial oint taken from the tube in the medicine
chest.  Not having read the article, I cannot challenge the assumptions that
they made to generate the $ amounts, but the results seem to be unbelievably
high.

Having said all this, I don't use much of these oints. I'm tired of
sensitization, especially in chronic wounds, and have been using eucerin or
petrolatum for years.


Guy Webster
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