NY Times: Cipro hoarding

greenspun.com : LUSENET : Grassroots Information Coordination Center (GICC) : One Thread

Headline: Anthrax Scare Prompts Run on Dubious Drug

Source: New York Times, 27 September 2001

URL: http://www.nytimes.com/2001/09/27/national/27DRUG.html

Many New Yorkers and to a lesser extent, people across the country are stocking up on Cipro, an antibiotic that they believe can be used to treat anthrax.

Most scientists say that taking Cipro after the appearance of symptoms of exposure to anthrax, a potentially deadly form of bacteria, is useless.

But Sebastian Manciameli, a pharmacist at Zitomer Pharmacy on Manhattan's Upper East Side, said: "We can't keep it in stock. It started the day after the World Trade Center, with a few prescriptions, and now there's more and more."

Mr. Manciameli added, "I usually keep 100 tablets in stock, but this time I ordered 3,000 and sold out. One person bought 1,000 tablets."

At the Village Pharmacy in the Boston suburb Brookline, Mass., Donald Silkes said that enough people had been asking about antibiotics to prompt him to place an extra order.

"They say, `I've spoken with my doctors and we decided this would be the best in the case of anthrax,' " Mr. Silkes said.

Many experts, however, say Cipro would probably be useless in treating anthrax. "We believe, based on animal studies, that once you're showing signs it's probably too late," said David R. Franz, a former official in the Army's germ defense establishment who is now vice president for chemical and biological defense at the Southern Research Institute at the University of Alabama.

Mr. Franz and others said that the United States had no detectors to routinely sample the air for anthrax, and that at any rate such an attack was considered unlikely. Experts in the field also pointed out that even if an attack with anthrax was tried, it would have only a slight chance of succeeding.

Many doctors see the push for antibiotics as an expression of the same panic that has led Americans to stock up on gas masks, handguns and bottled water. "We have 12,000 patients, and we've probably had 11,000 requests, but our policy is that we won't do it," said Dr. Michael Traister, a Manhattan pediatrician. "This is about fear, and it doesn't make a lot of medical sense. There are all kinds of possible agents of bioterrorism, and there's no reason to single out anthrax."

Last summer, Cipro, made by Bayer, became the first drug to win Food and Drug Administration approval for use in the event of a biological attack. At the time, the agency said that based on animal studies, the drug was "reasonably likely" to help humans fight off the disease, but only if taken soon after exposure to anthrax, which would be hard to detect. The agency said that 500 milligrams of Cipro, or ciprofloxacin, could be given twice a day to individuals who inhaled anthrax.

Many doctors and public-health officials say there is no cause to stock up on Cipro. They point out that neither Cipro nor any other antibiotic works on botulism, smallpox or other possible weapons of bioterrorism. "Theoretically, Cipro should work in an anthrax attack, but it's never been tested, so no one really knows the optimal dose or therapy, or even, for sure, that it works at all," said Dr. Vincent Quagliarello, clinical director of infectious diseases at the Yale University School of Medicine. "There is a risk that if anthrax were sprayed, thousands of people could inhale the spores and get sick. You have to inhale the spores to get sick; if you're sick, you don't give it to me. And as an agent of mass destruction, frankly, I'm much more scared about smallpox."

The federal government says there is no need for individuals to hoard Cipro. "We have a national stockpile, which includes Cipro, and we have delivery plans to bring it into any area in 12 hours," said Scott Lilybridge of the Department of Health and Human Services. "We believe there's a 24- to 36-hour window to initiate therapy."

-- Andre Weltman (aweltman@state.pa.us), September 27, 2001

Answers

Geez, the NYT is getting worse and worse...something I thought was not possible.

Does this paragraph

"Most scientists say that taking Cipro after the appearance of symptoms of exposure to anthrax, a potentially deadly form of bacteria, is useless.

Jive with this one --

"""We have a national stockpile, which includes Cipro, and we have delivery plans to bring it into any area in 12 hours," said Scott Lilybridge of the Department of Health and Human Services. "We believe there's a 24- to 36-hour window to initiate therapy."""

JB

-- Jackson Brown (Jackson_Brown@deja.com), September 27, 2001.


Actually, although it's not explained adequately, they do jibe. They are talking about two different questions.

The former statement is correct that once full-blown symptoms of anthrax develop, treatment is likely futile. Mortality will be essentially 100%.

The latter statement is correct with regard to primary prophylaxis, that is to say, PREVENTION of clinical illness. If you breath in anthrax spores *but are not yet sick*, taking antibiotic immediately (within the typical incubation period, which is something less than 2 days for most people but can be longer) may hopefully save your life.

(One textbook at my elbow suggests "Anthrax: Incubation typically 1-7 days, although in the Sverdlosk incident, incubations of as much as 60 days occurred.")

The trick is determining that anthrax has been released and getting antibiotic to as many people as possible *before they develop symptoms*. That's what the CDC "push package" (the National Pharmaceutical Stockpile Program) is meant to do.

(By the way, Scott's name is misspelled in the article, it's "Lillibridge.")

-- Andre Weltman, M.D. (aweltman@state.pa.us), September 27, 2001.


Andre --

Thanks for your insight!!!

It is still lousy reporting, that sends mixed message to the general public. The first paragraph was the worse needing some more of the "5 Ws" thrown in...like what and why.

The term "beginnings of symptoms" have no meaning with out definition.

Any reporter or editor worth a damn -- or just someone who can read semi-critically -- would understand that it did not convey any useful nformation or meaning.

Are they talking about early "flu like symptoms" most do hear about, or "full blown symptoms" that few know about. (I do, because I looked Anthrax up several years ago.)

I am not quibling about what YOU said!

I am just continually appalled at the level of jounalism, even with out bias issues, that passes for reporting. I worked for some of the best (and worse) papers in the 70s and the worse would do better than this in every case. Even "Junior" reporters would be fired if they couldn't do better...in short order -- and -- the editor would have caught it.

With the the New York Times, one should get better. They get their choice of the cream of the crop, but they still are getting worse and worse each year.

Thanks again for your comments!

JB

-- Jackson Brown (Jackson_Brown@deja.com), September 27, 2001.


You're welcome.

And I quite agree about the writing in the article.

-- Andre Weltman (aweltman@state.pa.us), September 27, 2001.


Moderation questions? read the FAQ