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© St. Petersburg Times, published October 24, 2001
Lost amid the public health establishment's call for calm about anthrax is the fact that stocking up on antibiotics isn't just a threat to public health. Even if you care only about yourself and your family, taking these drugs is misguided, dangerous and possibly deadly.
"It's a bad idea, a terrible idea" to self-administer an antibiotic, said Stuart Levy, an antibiotics expert at Tufts University School of Medicine in Boston. "People can and do die as a result of antibiotic misuse."
Antibiotics are "powerful, toxic drugs," said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases. You cannot simply pop these pills like vitamins to bolster your health in a time of increased risk.
Those taking a crowbar to Pandora's stash include people who have purchased Cipro -- the powerful antibiotic most often prescribed to treat people who have contracted an anthrax infection -- and then take it because they fear they may have been exposed to anthrax microbes. Unexposed people who take the drug at the onset of "flu-like symptoms" also put their health at serious risk.
To understand why, let's look at how Cipro works on people who do have the infection. Cipro kills most, but not all, of the anthrax bacteria. It keeps the bacteria's numbers low enough that the body's immune system can defeat the invaders. The anthrax bacteria, which release powerful toxins into body tissues, can multiply if untreated and can go into month-long dormant states to outwit the immune system. This is why Cipro must be taken for 60 days to treat anthrax.
Some anthrax bacteria can survive Cipro. These bacteria reproduce and pass along a protective trait, which is more likely to resist Cipro. But as long as Cipro kills the bulk of bacteria, the immune system can conquer the remains.
Should you stop taking Cipro prematurely when you have an anthrax infection, the bacteria continue to reproduce and overwhelm the immune system. You can start Cipro again, but your body is filled with the type of anthrax bacteria that is resistant to Cipro.
The more common scenario, the one that has health officials so inflamed, is when someone fears they have been exposed, but instead of consulting a doctor, they obtain Cipro and start taking it.
The drug does nothing to relieve the person's symptoms, which are likely the result of cold, flu or allergies -- none of which respond to antibiotics. Instead, the Cipro starts killing many different bacteria, including beneficial bugs.
This is bad for several reasons. The good bacteria are necessary for digestion and removal of oil on skin. And the presence of good or benign bacteria prevents harmful bacteria from gaining a foothold.
Antibiotics, like all drugs, come with quirks and side effects. Cipro's can be nasty. Cipro can cause nausea, diarrhea, allergic reactions, skin rashes, tremors and nerve damage. Also, Cipro may cause organ damage when taken with other prescription drugs. Antacids containing magnesium or aluminum hydroxide will bind to Cipro and can render it nearly ineffective.
In China, where antibiotics are readily available and their abuse is widespread, the majority of bacteria that cause urinary-tract infections and other life-threatening diseases are resistant to fluoroquinolone, the family of antibiotics that includes Cipro.
"The number of resistant strains (of bacteria) will inevitably go up" with this current abuse of Cipro in America, Levy said. "This is an experiment in (microbial) evolution that we do not need."
Then there is the fact that hoarders are reducing the supply for those who need the drugs. People with certain chronic illnesses, such as cystic fibrosis, rely on Cipro to breathe, as the drug can kill a recurring bacteria in the lungs.
According to Bayer AG, the maker of Cipro, this antibiotic is the primary drug treatment for a variety of common yet potentially deadly bacteria, such as pseudomonas aeruginosa, which infects weakened individuals in critical care and burn units. Cipro also cures many staph and strep infections -- far more common than anthrax.
If none of that dissuades people from stockpiling the antibiotic, the price may: A 60-day supply of Cipro costs about $600, or $5 a pill.