NEW YORK -- Pharmacies around the country have found themselves dragged into the war on bioterrorism, as the number of prescriptions for antibiotics to treat anthrax has surged and consumers have been questioning retail pharmacists about the disease.
After the Sept. 11 World Trade Center attacks, pharmacies here ran out of the antibiotic Cipro before the first traces of anthrax were even discovered in Boca Raton, Fla., three weeks later. New Yorkers apparently feared that a chemical contaminant might have accompanied the hijacked airliners. Since the Florida discovery, anthrax spores have also been found in New York and in Washington, and several people have been exposed to the deadly disease.
The situation has led people around the country to try to arm themselves with antidotes.
"Rite Aid has seen an overall increase of Cipro [sales], as well as a spike in New York above and beyond what is normal for this time of year," said Sarah Datz, spokeswoman, Rite Aid, Camp Hill, Pa.
She said the chain has not had problems keeping the drug in stock, although several sources said many pharmacies in New York City were completely out of the drug.
"A lot of pharmacies in New York have told me that they are out of Cipro," said Craig Burridge, executive director, Pharmacy Society of the State of New York, Albany. "It's being written by physicians prophylactically."
According to statistics from NDCHealth, Atlanta, prescriptions for Cipro in Florida totaled 19,390 in the week ended Oct. 5, vs. 16,836 in the comparable week from a year ago. Larger increases were reported in the New York area.
Wholesalers have also reported similar increases.
Although other antibiotics -- including doxycycline and some forms of penicillin -- are effective against naturally occuring anthrax, Cipro is being used in the current outbreak because it is believed that some lab-altered forms of the disease might be resistant to those other drugs, according to Dan Albrant, president, Pharmacy Dynamics, Arlington, Va.
West Haven, Conn.-based Bayer, the maker of Cipro, said it increased its production of the drug and said it expected to meet increased demands.
"I just think there's a lot of concern out there that we would not have enough Cipro if there was going to be a widespread attack," said Dave Hardin, director of pharmacy operations, K-VA-T Food Stores, Abingdon, Va.
He said his company's Food City supermarkets have not seen an increase in demand for Cipro, although he said customers have been curious.
"We've been fielding quite a few questions regarding Cipro and anthrax in general at the pharmacy counter," he said.
Customers have been asking about the effectiveness of Cipro, how to take it in case it is needed and whether pharmacies have enough of the drug on hand to treat patients in case of emergency. Harding said he was downloading information from the "Pharmacist Response Center" area of the American Pharmaceutical Association's Web site, aphanet.org, to distribute to pharmacists.
Despite the dangers of taking antibiotics without an appropriate diagnosis, pharmacists can do little to intervene.
"We don't do a lot of policing at the pharmacy level," Hardin said. "We would trust that the physician made a good judgment before writing the prescription."
Other retailers also said pharmacists could do little to prevent misuse of the drugs.
"If they have a valid prescription, we will sell that prescription," said Datz of Rite Aid. "We do not encourage or discourage patients to take a drug or not to take a drug."
At Walgreens, Deerfield, Ill., Carol Hively, spokeswoman, said the company's policy "is to empower pharmacists to use professional judgment in counseling patients."
She also said the retailer has seen demand for Cipro "increase slightly nationwide," with demand higher in the Boca Raton and New York areas.