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[e-drug] Possible intentional misinformation targetting prescribers!

E-DRUG: Possible intentional misinformation targetting prescribers!

Dear E-druggers,

I observed recently that a certain big pharma is marketing amoxicilline + 
clavulanic acid in a 500mg/62.5mg combination in two different names in 
Cameroon with a price difference between the two being 520 frs CFA (One Euro is 
655.9 frs CFA). What was even more interesting to me was that on the packets 
of�these medicines�I realized that it is boldly printed out in french "16 
comprimes pellicules = 8 prises"�(unfortunately my computer does not 
have the accent circumflex key). The quoted writing means that there are 16 
tablets to be taken in 8 doses i.e. two tablets two times a day.

I observed again that another big pharma markets the combination product as 
Curam with amoxicilline at 500mg and clavulanic acid at 125 mg. The packet of 
this Curam does not have any information concerning dosing but the paper insert 
informs that the dose is 1 tablet three times a day. Other generic products 
whose active substances are amoxicillin and clavulanic acid have the same 
strength as curam with the same dosing schedule.
Having made these observations, I turned my attention to the prescribing 
practice of these different brands and generic products. I realized that those 
prescribing Augmentin and Clavulin prescribed them as it is written on their 
packets (two tablets two times a day) while those prescribing Curam, Enhancin 
and Okaflox prescribe them as one tablet three times a day. 

I checked the correct dosing and saw that the BNF indicates that by mouth and 
when expressed as amoxicillin we should take 250mg every 8 hours, and when the 
infection is severe we double the dose.

My conclusion is that the Augmentin and Clavulin provide misleading information 
to prescribers and also increase the out-of-pocket expenditure of patients 
because they buy two packets instead of one. They may also contribute to 
antibiotic resistance because of the low dose of clavulanic acid and the poor 
dosing frequency
Has any one noticed this problem?
Chana Robert
Healthy Society
Core Pharmacy,
Box 332 Tiko

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