Book Review

Physicians' Desk Reference (PDR) Library on CD-ROM

N Engl J Med 1995; 332:757March 16, 1995

Article

Physicians' Desk Reference (PDR) Library on CD-ROM
CD-ROM with installation diskette (3.5) and manual. Montvale, N.J., Medical Economics Data, 1994. System needed: IBM PC or compatible, with DOS 3.1 or higher and at least 640 kilobytes of RAM. PDR library $595 (single user); PDR library plus Merck Manual $895 (single user).

In addition to the well-known 2600-page, single volume of the Physicians' Desk Reference (PDR), the PDR library includes three lesser-known books: PDR for Nonprescription Drugs, PDR for Ophthalmology, and the PDR Guide to Drug Interactions, Side Effects and Indications. All four books have been integrated on a single CD-ROM, resulting in a powerful and comprehensive drug data base.

The search capabilities of the CD-ROM are evidently much better than those of the book version. Besides the information one can get from drug handbooks, PDR on CD-ROM provides the clinician with the possibility of conducting a search according to side effects, therapeutic categories (indications), interactions, manufacturers, or words. For example, one can request all medications that are related to the Stevens–Johnson syndrome, those contraindicated in porphyria, or that interact with the combined treatment of warfarin, verapamil, digoxin, and prednisone. This information can be retrieved in seconds, whereas a manual search would probably take hours.

A useful feature of PDR on CD-ROM is the ability to check the possible interactions of an additional drug being considered for a patient who is already receiving multiple drugs. For example, a patient receiving nine different medications needs the addition of theophylline for asthma of new onset. The CD-ROM gives notice of a number of drug interactions and on request provides further details. It gives cross-references for each medicine on the list against all others, revealing many interactions hidden from the clinician. Information on two products can be displayed on a split screen for line-by-line comparison.

Another advantage of the CD-ROM is the quick and convenient answers it provides to specific and common questions. For example, it can show the recommended dosage and administration of a particular drug, especially when the drug is being considered in a problematic setting, such as renal insufficiency or liver disease. PDR on CD-ROM can also produce a well-organized, printed report that includes all the available information on a drug. Such a printout is useful both as a teaching aid and to refresh one's memory before prescribing uncommon drugs. Two minor sections that appear in the book version of the PDR have been omitted from the CD-ROM: one is the product-identification section, which contains photographs of medications, and the other is the section providing information on ophthalmic lenses and instrumentation, which can be found in the PDR for Ophthalmology.

It is possible to purchase a CD-ROM that includes, in addition to the four-volume PDR library, the full text of the Merck Manual of diagnosis and therapy (16th edition, 1992). In this configuration the opening menu allows the user to choose one of the options. The entire 2800-page Merck Manual can be searched either by table of contents (by viewing the list of chapters) or by index (by searching for key words). When we searched for “psoriasis” in the CD-ROM version of Merck, we found 31 entries, as opposed to only 3 listed in the index of the book version of the Merck Manual, 16th edition. Another advantage of the CD-ROM version is that multiple entries are shown simultaneously and can be easily compared.

The PDR library on CD-ROM is an indispensable tool for a busy practitioner, department, or research group, although the expense involved probably rules out its purchase by many individual physicians. The single substantial drawback we found in the package is the highly restrictive DOS interface. We look forward to the release of a Windows version, with its graphic and interface advantages.

Eytan Blumenthal, M.D.
Daniel Mimouni, M.D.
Hadassah University Hospital, Jerusalem, Israel 91120