While officials try to calm nerves and urge Americans not to stock up on antibiotics out of fear of a biological attack, Web sites touting antibiotics prey on these fears, health officials say.
One Web site was offering an anthrax 30-day prevention pack for $279. Other Web sites were offering Ciprofloxacin, or Cipro as it is commonly called, and gas masks.
Cipro is the most widely used antibiotic for anthrax treatment, but it can have severe side effects, and doctors warn against taking it unless really necessary or without proper medical supervision.
"These Web sites are capitalizing on people's fears," said Carmen Catizone, executive director the National Association of Boards of Pharmacy. "We have seen some sites that are just disgraceful. They have advertised on their site gas masks and Cipro and it's very exploitative."
Among other side effects, which include dizziness and nausea, Cipro inhibits bone growth in pregnant women and in children. Anyone taking Theophylline, an asthma medication, is at risk for serious reactions if they take Cipro, and should consider an alternative.
The American Medical Association points out that it's easy to lie on the Web site questionnaires that need to be filled out to get the prescriptions, and that without a doctor's supervision, it's much harder to catch potential problems.
Getting a prescription from a Web site based on a simple questionnaire does not "sufficiently meet the standards for good medical care," said a statement from the AMA.
Fears of Resistance
Doctors and the AMA also warned that improper use could lead to strains of disease that are resistant to treatment.
The AMA has posted a warning on its Web site advising physicians, in part that, "Antibiotic resistance is a real public health concern. Infectious agents develop resistance to antibiotics. The more often an antibiotic is used, the greater the chance of resistance developing."
Officials also warned that stocking up on anti-anthrax medication could leave shorter supplies for people who really need it.
Health and Human Services Secretary Tommy Thompson asked Americans not to buy and hoard the pharmaceuticals, although there is some controversy over whether the country has enough drugs on hand. Claude Allen, HHS deputy secretary, told the House Committee on Veterans Affairs that part of $1.5 billion the department has requested, would be used to increase the pharmaceutical stockpile of anthrax treatment.
The $1 billion-a-year drug, manufactured by German drugmaker Bayer AG, has been used in the United States since 1987 to treat a variety of infections. The Food and Drug Administration approved it for anthrax treatment last year. Fear of anthrax infection has taken hold across the country and even in Europe where several recent scares have been reported.
People Want the Drug
Dr. Daisy Merey, who runs a family practice in West Palm Beach, said she prescribed Cipro for several people who wanted it around just in case they got sick.
"A lot of people who are coming in for checkups are also asking about Cipro," Merey told Reuters. "We don't recommend taking antibiotics as a preventive measure because there are side effects. If people really want it just to have in case something happens, we'll prescribe it to them."
One reason doctors don't like to have people procuring prescriptions for Cipro online is that it's a very strong antibiotic that is generally reserved for tough cases, said Dr. Nancy Snyderman on ABCNEWS' Good Morning America.
"It's not even a first-line drug of choice for most infections," Snyderman said. "This is a kind of medication you use when other things fail."
Since anthrax doesn't widely disperse itself, there is no need to stock up on Cipro, said Stephen Ostroff, chief epidemiologist at the Centers for Disease Control and Prevention in Atlanta.
"And in all of the current situations that we're aware of, it's really mostly been confined to people who've had direct contact with these contaminated envelopes," Ostroff told Good Morning America.
Furthermore, if someone gets a subscription for Cipro and has an allergic reaction, they may have nowhere to turn for help, Snyderman said.
"Pharmacies aren't always open," she said. "Your local doctor might not even know you have the medication and certainly 911 has been flooded, those lines have been flooded with real credible concerns for all different kinds of problems. So, the whole system is backwards."
She recommends that people with real concerns see their doctor and heed warnings about opening suspicious packages.