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Ajit P. Limaye, MD; Douglas S. Paauw, MD
University of Washington Hospital and Medical Center Seattle

JAMA. 1997;278(19):1568-1569.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Dr Westfall and colleagues¹ raised ethical concerns regarding the frequent personal use of drug samples by medical personnel. We report on Clostridium difficile—related diarrhea as a complication of this practice in medical house staff who have ready access to pharmaceutical samples of antibiotics and frequent exposure to the organism in the hospital setting.

A 26-year-old, otherwise healthy medical resident with self-diagnosed sinusitis began a course of amoxicillin-clavulanate samples that he had received from a pharmaceutical company representative. Ten days later he experienced crampy abdominal pain and watery diarrhea. He suspected C difficile—related diarrhea and empirically began a course of metronidazole until stool studies demonstrated C difficile by toxin assay (cultures for enteric pathogens were negative). His diarrhea responded to 10 days of oral metronidazole, but he experienced a relapse 4 weeks later that also responded promptly to re-treatment with the same regimen.

A 28-year-old, otherwise . . . [Full Text PDF of this Article]

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