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Cipro
Stockpiling Opening Pandora's Box Boston [10.22.01] -- While there have been less than a dozen anthrax infections since the Sept. 11 attacks, public anxiety about the deadly bacteria has made Cipro -- the drug used to treat anthrax infections -- the hottest prescription on the market. But unnecessary use of the powerful antibiotic may open a Pandora's box, says a Tufts expert and ultimately endanger many more people than the bacteria it's prescribed to treat. There have been widespread reports that many Americans are stockpiling the drug as a precaution. Others have reportedly taken Cipro after experiencing a variety of common symptoms, just to protect against the possibility that they are anthrax-related. "My concern is people have it on their shelves and I try to look at human nature," Tufts' Dr. Stuart Levy told The Boston Globe. "They will use it if they get even a cold or cough." Already a powerful weapon against anthrax and other infections, Cipro could lose its effectiveness quickly if overused, said the expert on antibiotic resistance and director of the Center for Adaptation Genetics and Drug Resistance at Tufts' School of Medicine. And that could be very dangerous. According to the Hartford Courant, "Doctors fear that widespread misuse of Cipro will render it worthless, as a host of normal pedestrian but potentially deadly infections evolve the ability to resist the drug." In an interview with CBS Morning News, Levy reinforced that point, saying: "If there is an intense use of Cipro in one community, in a household, then you see that the whole area would be rid of the susceptible strains and the resistant ones would come to replace them." Using the antibiotics for just a few weeks would likely generate resistant strains of bacteria in a patient, the Tufts scientist said in a New York Times article. Already, there is evidence that some bacteria are already resistant to Cipro. Overuse in Asia, for example, has caused Cipro to quickly lose its power in that region. "The drug could once treat gonorrhea everywhere in the world, for instance, but it can be no longer used in Asia and cases of resistant gonorrhea in the U.S. are increasing," reported the Times. Similar resistance could evolve among the bacterial infections associated with cystic fibrosis, pneumonia, E. coli, blood-borne and urinary tract illnesses -- all of which are treated with Cipro, sometimes as a last defense. "You're going to see a huge change in the microbiology of the world in which we live, to the detriment of a drug that's critically important to many of our patients," Levy told the Washington Post. "It's an experiment in evolution we're witnessing." Ironically, there are other ways to treat anthrax that would reduce the public's obsession with Cipro. "Older antibiotics, such as penicillin, that cost pennies a dose would be just as effective at combating the strains of anthrax discovered in Florida, New York and Nevada as Cipro, which costs $4 to $5 a pill," reported the Hartford Courant. With flu season quickly approaching, the problem is likely to get worse. According to the Courant, "Levy fears that after spending $500 to $600 for a 60-day supply of Cipro, people who fear an anthrax exposure will take the pills if they get sniffles during flu season, even though antibiotics are worthless against viral infections." Instead, the internationally renowned Tufts expert is urging restraint. "My advice to those people who are hoarding them is don't use them," Levy told the Courant. "Think of it as opening a Pandora's box." The key, Levy says, is not to fall victim to fear. "Put reams of Scotch tape around it and don't take it unless you hear from the public health authorities that you are involved in a bioterrorism event" he told the Washington Post. Online: http://www.tufts.edu/communications/printerversion/102201LevyOnCipro
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