Letters

I have just finished reading your April 18 cover story, "Staving Off Allergies." The portion on cross-sensitivity of the penicillins and cephalosporins could have a dramatic impact on the choice and use of antibiotics for prophylaxis prior to surgery.

We would like to further evaluate the evidence and references used in your article prior to recommending changes at this facility.

Jan Baetke, R.Ph.
Manager, Pharmacy Services
Aurora Medical Center
jan.baetke@aurora.org

Why license transfers rose The reason Nebraska and Louisiana had such an increase in transfers into their states, as reported in your May 2 issue, is that their legislatures passed laws that required out-of-state mail-order pharmacies to have their pharmacist-in-charge licensed in their state in order to ship medications into the state. You will find Kentucky with an increase this next year, as it has adopted a similar requirement.

Larry Schallockrxlarry@cox.net

Preserve compounding In your April 18 issue, you reported that some national consumer groups are dissatisfied with the practices of compounding pharmacies. Before we throw the baby out with the bathwater, let's set the record straight.

One should not confuse the efforts of legitimate compounding pharmacies with those activities of clandestine manufacturers. A compounding pharmacy will adjust an existing product only to meet a specific patient need. As recently upheld by the U.S. Supreme Court, a pharmacy is operating normally as long as it is meeting a specific patient's need for a specific type of product not already available commercially. When someone is copying an already commercially available product solely for economic reasons, it has crossed the line between compounding and manufacturing.

As pointed out in your May 2 issue, pharmacy is taking another step by establishing a voluntary accreditation process. Any reasonable compounding pharmacy will take advantage of this process as a means to establish its credibility. Consumers should be advised to look for this accreditation as a "gold standard." If they find a questionable product, tell them this: "When in doubt, seek us out." Pharmacy will help, for every pharmacy practice act in this country has as its main goal "protecting the public."

Dennis Bryan, R.Ph., MBA, FAPhA
Chicago
tatobryan@aol.com

From white to black jacket Regarding your May 2 Breaking News item on the Wisconsin pharmacist Neil Noesen, who was sanctioned by the pharmacy board for refusing to fill an Rx for oral contraceptives on religious grounds, perhaps Mr. Noesen should trade in his white Rx jacket for a black cassock and proselytize at the pulpit instead of the counter.

Jeff Burger, R.Ph.
New City, N.Y.
jmburger@optonline.net

Buck stops with owners In reply to an April 18 letter on pharmacists being the sole authority for final checks, I strongly disagree with B. J. Khalifah's opinion. He stated, "The most important question to be asked is not who should do the checking, but who is responsible-legally, financially, and under liability insurance-for that prescription."

In our pharmacy, and as in the Navy's, the owner is more financially responsible and under more liability insurance than the R.Ph. I am not a pharmacist, but I own the pharmacy. I hold the state and federal licenses that allow the R.Ph. to practice pharmacy in my establishment. In other words, without my licenses and liability, the pharmacist cannot even show up for work. If the pharmacist disagrees with the way the pharmacy practices, he can leave and another pharmacist will be hired.