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.