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Anthrax scare has many seeking antibiotics

Although there have been relatively few confirmed cases of exposure to anthrax, thousands of people across the country have become unnerved by the possibility of being exposed.

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This has led many people to call their physicians, seeking a prescription for Cipro or doxycycline, the antibiotics most commonly prescribed to combat anthrax. Some consumers, turned away by doctors who are refusing to prescribe the drugs without evidence of exposure, are now turning to web sites that sell the anti-anthrax medications online.

"Antibiotics are like car batteries. The more you use them, the more they wear down."

Federal authorities say many of these web sites are illegal online pharmacies. They're charging consumers anywhere from $50 to $100 to complete a health questionnaire purportedly reviewed by a "doctor," who then prescribes medication such as Cipro for as much as $10 per pill. This is far more than consumers would pay at traditional pharmacies.

Federal officials worry consumers, who buy Cipro or other medications from online pharmacies, have no idea who is selling them the drug or what they are getting.

"When people are frightened or teased by the claims of the effect of a drug such as Viagra, they've just got to have it," says Dr. Charles Aswad, the executive vice president of the Medical Society of the State of New York (MSSNY). When they purchase that drug online, according to Dr. Aswad, they often "don't know if they're getting a legitimate or bogus product."

AMA statement on Cipro

"There is no indication for the widespread prescription of antibiotics to prevent anthrax, and no indication for the prescription of antibiotics to have on hand in case of a future incident."

According to the Centers for Disease Control and Prevention (CDC) and the American Medical Association (AMA), inappropriate or overuse of antibiotics can cause germs to become drug-resistant, reducing the arsenal doctors have to treat serious illness

"Antibiotics are like car batteries," says Dr. Timothy Flaherty, a trustee of the AMA. "The more you use them, the more they wear down."

As new cases of anthrax exposure appear, some family physicians have come under intense pressure from patients to prescribe Cipro and other anthrax-fighting medications.  The California Medical Association has sent letters to its member physicians urging them to reject inappropriate patient requests for Cipro.

Additionally, several major California health insurers, including PacifiCare Health Systems, now require a doctor's explanation and pre-approval by the health plan before they'll pay for more than a 14-day supply of Cipro, according to PacifiCare spokesman Ben Singer.

"Have Cipro by tonight!"

Some web sites claim you can "Have Cipro by tonight!" and "Have Cipro, no script required!" One web site lets you e-mail the online pharmacist, but there is no telephone number to call if you have questions

Internet prescribing, without appropriate safeguards, falls below a minimum standard of medical care.

While some drug-dispensing web sites are legitimate businesses, the AMA claims prescribing drugs over the Internet, without appropriate safeguards, falls below a minimum standard of medical care. Those standards include:

  • An examination of the patient to determine whether there actually is a medical problem.
  • Dialogue with the patient to discuss treatment alternatives and to determine the best course of treatment.
  • An attempt to establish a reliable medical history.
  • Information about the benefits and risks of the prescribed medication.
  • A follow-up to assess the therapeutic outcome.

The U.S. Food and Drug Administration (FDA) urges consumers to be wary when buying any medication online. The FDA warns consumers it’s very easy to set up a professional-looking web site that promises deep discounts and no hassles. In order to protect themselves, the FDA urges consumers to:

  • Check with the National Association of Boards of Pharmacy to determine whether a web site is a licensed pharmacy in good standing.
  • Avoid sites that offer to prescribe a drug for the first time without a physical exam, sell a drug without a prescription, or sell drugs not approved by the FDA.
  • Stay away from web sites that have no access to a registered pharmacist to answer questions.
  • Avoid sites that do not identify with whom you are dealing and do not provide a U.S. address and phone number to contact if there's a problem.
  • Watch out for foreign web sites, because it’s generally illegal to import the drugs bought from these sites. The FDA warns the risks are greater, and there is very little the U.S. government can do if you are a victim of a foreign web site scam.
  • Beware of sites that advertise a "new cure" for a serious disorder or a quick cure-all for a wide range of ailments.
  • Be careful of sites that use impressive-sounding terminology to disguise a lack of good science or those that claim the government, the medical profession, or research scientists have conspired to suppress a product.
  • Steer clear of sites that include undocumented case histories claiming "amazing" results.
  • Talk to your healthcare professional before using any medications for the first time.
  • Report any web site you think is illegally selling human drugs, animal drugs, medical devices, biological products, foods, dietary supplements, or cosmetics to the FDA.

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