Inappropriate prescription. I just said erythromycin does not include most Gram negative in its spectrum. Hey, you've got a Gram negative infection. You don't need erythromycin. You're not going to get better. Wrong indication. Or overkill - In our society, we have the liability clauses for the physician. It's easy for me to criticize a physician that might say, "Wait a minute, just because there is a patient way over in the other wing of the hospital that's receiving vancomycin because there is a methicillin resistant Staph. aureus (MRSA) over there, I'm going to make sure my patient is going to take that drug." Rather than saying, "Oh no, my patient doesn't have MRSA. I'm going to give my patient this methicillin and I don't worry about giving my patient methicillin". I'm not sure I would say it and actually take the action if I were in the place of the physician having the liability. Hopefully, we'll get better at handling that situation.

Non-compliance of hospital staff in good health practices. This is very simple like washing your hands. There are some basic principles of sanitary conditions that can be improved upon greatly. Non compliance, not taking the whole prescription. One of the things we talked about was not taking the full prescription for strep throat and things of that sort. You want to take the whole prescription and at the times and conditions indicated. There's a beaut! (use of outdated drugs and/or passing them on to others) I bet you know people who have told you they haven't done it and maybe have. Saving old drugs and passing on to another member in the household. That's really dangerous. Hopefully we don't have to ever put that down on a slide in the future. More frequent international travel. For instance, I heard someone cough just now. I came from the East with adenovirus. I hope I didn't cause that cough. But that's how quickly some diseases can be spread. I could have Ebola. I don't, by the way. Not that I know of. But another cough. Not sneezing though, that's good. But that's a matter of common practice in our society today, how rapidly we travel from place to place. Unfortunately, that's one that we have to deal with. I don't know how well we're going to deal with that. That's a real tough one.

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