Originally created 10/18/01

Don't take Cipro unless you need it



Doctors are warning that inappropriate use of a potent antibiotic to guard against anthrax could wind up exposing Americans to dangerous infections of drug-resistant bacteria.

Faced with growing concern of terrorist attacks, health experts began issuing new alarms this week about the dangers of over prescribing the drug Cipro, one of the last and best weapons in the arsenal against routine bacterial infections.

Hundreds of employees of NBC News in New York and American Media Inc. in Florida - where anthrax has been found - have been placed on a 60-day course of the antibiotic because it can prevent the spores from blossoming into a deadly blood infection.

Thousands more Americans are seeking supplies of the drug in the wake of terrifying stories of anthrax popping out of envelopes mailed to news organizations and most recently the offices of Senate Democratic leader Tom Daschle.

The danger is that people taking Cipro, the trade name for ciprofloxacin, can breed microbes in their bodies resistant to the antibiotic - placing themselves and those around them in jeopardy.

"If we lose Cipro, we lose a very important antibiotic," said Dr. Carol Baker, president of the Infectious Diseases Society of America, an Alexandria, Va., organization of 6,000 specialists in viral and bacterial infections.

Some doctors are also questioning the use of ciprofloxacin in the Florida anthrax incident, because disease investigators learned early on that the strain there was treatable with other antibiotics, such as penicillin and doxycycline.

Because anthrax spores in the body can bloom as long as 60 days after exposure, patients taking antibiotics to prevent the disease must keep doing so for the same two-month period. That's much longer than common usages of ciprofloxacin, where the course of treatment is five days to two weeks.

"The chances that somebody will get into serious trouble because of antibiotic resistance are much higher than the risk they would get anthrax," Baker said.

Ciprofloxacin also carries with it a range of unpleasant and occasionally dangerous side effects. It is not recommended for pregnant women or nursing mothers. It is not recommended for children because it can cause abnormal bone growth and joint disorders.

The biggest danger of antibiotic resistance occurs when a patient's own supply of harmless bacteria in the digestive tract are killed by the drug. There will likely be a small number of bacteria that survive the antibiotic because they have a natural resistance to it. And if these bacteria later cause a bladder infection - a common condition treated with Cipro - the drug won't cure it.

"Instead of simple bladder infection, it may be a resistant kidney infection, with fever," Baker explained.

(Distributed by Scripps Howard News Service.)