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Pharmacists in New York have sold greater-than-normal
amounts of antibiotics for treating anthrax, a highly contagious
and potentially fatal disease, amid rising fear of biological
warfare after the attacks on the World Trade Center.
Though sales of antibiotics normally
rise in September when children return to school and parents
are concerned about their exposure to infections, pharmacists
said the sale of Bayer AG's
anti-microbial drug Cipro are much higher than usual.
Cipro, the German drug maker's best-selling
drug, is used to treat a number of diseases and infections,
including anthrax, a disease that can cause bleeding blisters,
difficulty in breathing, shock and coma. Even with early treatment,
the inhalation of anthrax spores is almost always fatal.
"We're hearing that Cipro
is a front-line defense against anthrax and in
the last couple of days I've sold about a month's worth,"
said Barry Reiter, chief operating officer of Brooklyn-based
Remo Drug Corp., one of the largest independent pharmaceutical
supply companies in America.
"Today we'll be out of stock and
we've already reordered," Reiter said Tuesday.
The US Federal Aviation Administration
on Tuesday said crop-duster planes could fly again after they
were grounded for 2 days because of rising fear of biological
or chemical attack in the wake of the September 11 hijacked
jetliner attacks in New York and outside Washington, DC.
Bayer said it sells worldwide about $1
billion a year of Cipro, a drug used to treat urinary tract
and gastrointestinal infections, as well as pneumonia and
bronchitis. The drug was approved
by the US Food and Drug Administration to treat exposure to
anthrax in August 2000 and it is the only orally
administered drug recommended for such use by the Centers
for Disease Control and Prevention in Atlanta.
The dosage to treat anthrax is two pills
a day for 60 days, while a patient suffering from a gastrointestinal
infection would take two of the Cipro pills a day for about
a week.
Cipro
Demand Soars
Sylvia Lifshitz, a pharmacist at independent
Drug Mart on Manhattan's Upper East Side, normally prescribes
about 300 Cipro tablets in a 2- to 3-week period.
Over the first weekend after the World
Trade Center attacks, however, Lifshitz dispensed about 1,000
Cipro tablets in 3 days.
"I've never done that before,"
Lifshitz said, adding that most of her customers have been
"highly educated and highly neurotic."
Lifshitz ordered extra Cipro, which cost
about $1 a tablet, after New York physicians began prescribing
it for themselves and their families, and currently has a
stock of about 1,200 pills in the store, even though she is
uncertain of its efficacy against anthrax.
Robert Berman, co-owner of Kings Pharmacy,
which has six stores in New York City, including one near
the World Trade Center, said he has also seen a large rise
in requests for Cipro.
"I had one guy come in and buy a
2-month supply for him and his wife," said Berman.
Chain drug store Rite Aid Corp., which
has 30 stores in Manhattan, said more antibiotics normally
are sold in September, though it had not noticed an unusual
rise in the sale of Cipro.
Cipro is not the only antibiotic available
for treatment of inhaled microbes. Generic doxycycline,
usually prescribed to prevent traveler's
diarrhea, is another antimicrobial drug that normally sees
a rise in sales in September.
"People are panicking, and we've
had more than the usual number of inquiries about doxycycline,
too," said pharmacist Gary Halpern at the Caligor Pharmacy
on Manhattan's Upper East Side, most of whose business has
come from selling vaccines.
No
Supply Shortage
David Siegrist, a research fellow and
the director of studies for the Countering Biological Terrorism
program at the Potomac Institute for Policy Studies in Arlington,
Virginia, said there was a reason for doctors' choosing Cipro
first.
"It's believed that terrorists
could make their anthrax resistant to doxycyline, but Cipro
is more complicated," Siegrist said. He said
that Cipro is the antimicrobial drug of choice for the US
military, which bought doses for the troops that served in
the Gulf War in 1991.
"It wouldn't hurt to have a little
Cipro on hand now," Siegrist said.
Pharmacists
need not fear of a supply shortage, said Bayer,
which makes the drug in a plant in West Haven, Connecticut,
and in Europe.
"We've got no supply issues at this
point and people should rest assured that we have been working
with the CDC and the Department of Defense for over a year,"
said spokesman Rob Kloppenburg.
Reuters October
2001
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