A jump of nearly 50 percent in prescriptions nationwide for the anthrax drug Cipro shows that many doctors and patients are shrugging off government pleas against stockpiling for personal use, medical and industry experts say.
In the New York City area, prescriptions nearly tripled, drug marketing data indicate.
Spurred by news reports on potential bioterrorism, sales of the antibiotic began climbing right after the Sept. 11 air attacks and weeks before the first news of an anthrax case on Oct. 4, according to a national marketing consultant that surveys pharmaceutical retailers.
The numbers are apt to rise more still as they are released in coming weeks, because the latest data go only as far as Oct. 12 _ before the last anthrax deaths and widespread Cipro treatment for postal workers.
``I've been trying to hold back my own friends and relatives who are trying to get this stuff,'' said Dr. Stephen Baum, at Beth Israel Medical Center in New York. He is president of the New York Society of Infectious Diseases.
The run on Cipro is deepening worry about potential shortages of an important drug for fighting many infections, side effects in more patients and the buildup of antibiotic resistance in the germ.
Drug and disease specialists say the winter flu season could aggravate things, because anthrax can create flu-like symptoms. They fear people will start popping stockpiled Cipro for the sniffles, and others will overwhelm the medical system with demands for treatment.
``I can't tell you what my fears are about what this is going to do to the health system. As people start to get their normal coughs and colds, their first thought is going to be ... anthrax,'' said Daniel Albrant, president of Pharmacy Dynamics, a pharmaceutical consulting company in Arlington, Va. He said flu shots are especially important this year.
The weekly Cipro prescription numbers, which were supplied by drug-marketing consultant NDCHealth of Atlanta, are projected from a survey of 66 percent of the national retail and mail-order market.
Starting Sept. 8, new Cipro prescriptions have risen in all but the second week. For the week ending Oct. 12, there were 353,440 new prescriptions sold at retail and mail-order outlets, compared to 237,368 for the week ending Sept. 7. That's a 49 percent increase, with the biggest single-week rise of 24 percent in the week ending Oct. 12, after the first anthrax death.
Weekly prescription numbers show some normal week-to-week fluctuations, so it is hard to know exactly how much of the increase can be blamed on anthrax worries. However, by comparison, last year's October prescriptions for Cipro held steady around 250,000.
Increases were especially heavy in Washington too, which together with New York suffered the brunt of the Sept. 11 attacks. In Washington, new prescriptions went up 67 percent, according to the NDCHealth data.
The company's data excludes Cipro supplied by health authorities at sites of germ contamination, as well as illegal sales without a prescription.
Frank Odeh, a pharmacist on Capitol Hill, said many doctors write a Cipro prescription for patients simply worried about anthrax so they don't lose the business when they ``upset their patients.''
``They'll just go to another physician who will write it,'' he added.
No major shortages have been reported so far, though there have been distribution kinks. ``I had to really wait and ask and pester them,'' said New York City pharmacist Joel Zive of his distributors.
Ron Streck, president of the Health Care Distribution Management Association, said shortages are possible if sales keep catapulting. His group, based in Reston, Va., represents wholesalers and other companies in the pharmaceutical distribution chain.
``It really depends on how much has been taken from the system,'' he said. ``If we have runs on pharmaceuticals, you can't predict where we will have shortages.''
Some other antibiotics are effective against anthrax, but Cipro is the most popular. Government officials have asked Americans fearful of anthrax to buy antibiotics only if they suspect exposure to the germ.
Otherwise, they could jeopardize the supply for hospitals, which give Cipro as a drug of last resort for a variety of infections. People can suffer allergic and toxic side effects from Cipro. Its retail cost is also steep _ about $4.50 a pill. A 60-day regimen for anthrax retails at around $500.
The patent-holding maker of Cipro, Bayer Corp., has been ramping up retail production to 100 million tablets by mid-January, spokeswoman Andrea Calese said Thursday. That is in addition to the 100 million pills the company agreed to supply to the U.S. government for emergency use at a cost of 95 cents apiece.
The government is stockpiling Cipro for use where it is most needed in a national emergency. However, some White House personnel were given Cipro six weeks ago without reports of germ contamination there.