AMA: Drugs are for anthrax, not fear

News accounts have revealed that dozens of people in the United States were

potentially exposed to the anthrax bacterium in acts of bioterrorism. These

reports have triggered public inquiries about who should take antibiotics to ward

off anthrax infections.

This week, the Chicago-based American Medical Association (AMA) issued an advisory

to physicians arguing that such prophylactic use of antibiotics might do more harm

than good. The AMA noted that such use of the drugs could foster antibiotic

resistance in anthrax germs–rendering these drugs useless in the future, when they may be truly needed.

Over the past few weeks, public health officials have distributed or prescribed

ciprofloxacin and other antibiotics to people who handled envelopes containing

powders carrying anthrax spores. “And I think that’s appropriate,” says Timothy

Flaherty, chairman of the AMA’s board of trustees, “at least for the time it takes

to test and make sure these people aren’t infected.”

The most important thing that doctors can do, the AMA says, is familiarize

themselves with symptoms of bioterrorism agents, such as anthrax, “and be vigilant

in reporting possible cases.”

Two years ago, the AMA’s Working Group on Civilian Biodefense reviewed data on

anthrax as a biological weapon. Its 11-page consensus statement concluded, “There

are no data to suggest patient-to-patient transmission of anthrax occurs.”

Therefore, it argued, asymptomatic family, friends, and coworkers of infected

people don’t need the anthrax vaccine or antibiotics “unless a determination is

made that they, like the patient, were exposed.”

Flaherty told Science News, “As we go forward with this anthrax situation, it’ll be important to test the sensitivity of particular strains of anthrax to

antibiotics.” Strains naturally occurring in U.S. soils, he notes, are usually

sensitive to penicillin. Doctors may be able to reserve ciprofloxacin for other

anthrax strains. But even that may not work if the bacteria have been genetically

altered, Flaherty says.

Janet Raloff is the Editor, Digital of Science News Explores, a daily online magazine for middle school students. She started at Science News in 1977 as the environment and policy writer, specializing in toxicology. To her never-ending surprise, her daughter became a toxicologist.

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