Abstract
To the Editor.— All agree that there has been overuse of antibiotics in the United States. One aspect is not clear to us because of astonishing absence of data. That is: Have we gained from the widespread use of antibiotics? Before the antibiotic era, suppurative diseases involving the sinuses and the middle ear were quite common. Mastoidectomy and sinus operation were common procedures everywhere in the United States. With the advent of antibiotics, they have become rarities. However, otitis media is still common among the American Indians and the Alaskan Eskimos. If the American Indians and Alaskan Eskimos received the same amount of medication as in the rest of the country, the high incidence of suppurative otitis media might not have occurred. This is just one example; no one knows how many others might exist. While we know so much about the adverse effects of the overuse of antibiotics, we
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