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Thursday, 25 October, 2001, 00:42 GMT 01:42 UK
Cipro demand outstrips supply
Bottle of Cipro
Fear of anthrax has led to a surge in demand for Cipro
Kevin Anderson

Americans are travelling to Mexico, logging on to websites and visiting their local pharmacies - all in an effort to get Cipro, the antibiotic most widely reported to treat anthrax.

Despite calls from public health officials not to stockpile the antibiotic or take it unnecessarily, pharmacies are still seeing increasingly strong demand for the medication.

Most Americans have never been in a situation like this, and it is a panic situation

Arthur Weinstein, pharmacist
And officials fear that overuse of the antibiotic could lead to strains of bacteria that are resistant to Cipro.

Pharmacies cannot keep up with requests for antibiotics to treat anthrax.

"We are seeing more demand than we can supply," said Arthur Weinstein, a pharmacist in Washington.

Most patients coming to him are asking for ciprofloxacin, sold by Bayer under the brand name of Cipro.

And if anything, the demand has been increasing in the past week, as the public learned that two postal workers had died from anthrax.

"We went through 500 tablets in less than five hours a couple of days ago," said Mr Weinstein.


It was a couple of days before they received a new shipment, and Mr Weinstein said that of the 300 tablet supply he received, half of it was already gone only four hours after they took delivery of the shipment.

A lot of the people coming in are scared, he said, and he is surprised because more than half of those asking for the antibiotics are doctors and nurses.

US postal worker holds package
US postal workers feel highly at risk to exposure from anthrax

"They should know better. They shouldn't be as frightened as they are," he said.

But some Americans are panicked by the outbreak of anthrax.

"Most Americans have never been in a situation like this, and it is a panic situation," he added.

In New York, demand for Cipro has increased 203% from the week ending 14 September through the week ending 12 October, according to NDCHealth, a drug research company.

Nationally during the same period of time, the number of Cipro pills dispensed has increased 41%, according to the company.

Mr Weinstein said: "Cipro seems to be the one that's got the most press, and people seem to think that it is the only one they think will work against anthrax."

Trying to instill calm

Public health officials familiar with the cases say the strains of anthrax discovered in New York, New Jersey, Washington and Florida all appear to be treatable with a range of antibiotics and other drugs.

Contrary to some reports in the press, Cipro is not the only antibiotic approved by the US Food and Drug Administration to treat anthrax.

Cipro capsules
Health officials fear the huge demand for Cipro could dry up supplies

The FDA also suggests the use of penicillin and doxycycline.

These older antibiotics have been shown effective, and they are often much less expensive.

Mr Weinstein said that Cipro costs about $5 a tablet.

Most patients are limited by their insurance plans to a 20 to 30 day supply of the drug.

At two tablets a day, that still adds up to $300.

The FDA is stressing that any antibiotic should only be used by those who really need it because unnecessary antibiotic use exposes patients to the risks of a drug without any potential benefit.

Drug-resistant strains

Public health officials fear that indiscriminate use of Cipro could lead to short supplies of the antibiotic and could also cause drug resistant strains of diseases.

Overuse of antibiotics can cause bacteria to become resistant to previously effective antibiotics

Dr Timothy T Flaherty, American Medical Association

"Overuse of antibiotics can cause bacteria to become resistant to previously effective antibiotics," said Dr Timothy T Flaherty, chair of the American Medical Association.

And the FDA is strongly recommending that physicians not prescribe Cipro for individual patients to have on hand for possible use against inhaled anthrax.

The drug should not be prescribed unless there is a clear need.

If someone is exposed, drugs will be made available from current stockpiles, the FDA says.

"The federal government has stressed that antibiotics for the treatment of anthrax are stockpiled in several areas in the nation, and they can be delivered to any airport within 12 hours," Dr Flaherty said.

See also:

24 Oct 01 | Americas
'No guarantees' US mail is safe
24 Oct 01 | Business
US and Bayer settle anthrax row
24 Oct 01 | Americas
Q&A: The anthrax mystery
24 Oct 01 | Americas
Anthrax: Charting the US cases
24 Oct 01 | Americas
White House post room hit by anthrax
23 Oct 01 | Business
Bayer beats Canada in anthrax row
23 Oct 01 | Business
America's anthrax patent dilemma
16 Oct 01 | World
The threat of bio-terrorism
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