10/23/01

AU PHARMACY PROFESSOR WARNS AGAINST OVERUSE OF ANTIBIOTIC CIPRO

AUBURN -- An Auburn University infectious disease expert says the overuse and stockpiling of the antibiotic Cipro in reaction to the anthrax scare could pose as many problems as it solves and that other, more traditional antibiotics would likely prove equally as effective.

C. Michael Reinke, an associate professor of clinical pharmacy practice, who specializes in infectious disease, says the stockpiling and preventive use of Cipro is a "terrible idea."

"Therešs very little logic behind the notion that the common citizen would be targeted (by anthrax) unless they happen to be one of those unfortunate individuals who work in a mail-sorting room or some other location where they could be randomly affected," he said. "In Alabama, unless you're someone high in state government like the governor or something, I would think your chances for anthrax exposure are very low."

Reinke added that ciprofloxacin, which Bayer Corp., markets under the trade name Cipro, has also been shown to have the potential for a number of adverse effects.

"Any drug has hazards," he said. "You always need to weigh the benefit you accrue from taking it with the risk you take. In fact, it's very rare, but there have been cases where people have taken this drug and died very quickly because of an allergic reaction."

Other adverse effects, Reinke said, include central nervous system affects ranging from insomnia to, in very rare instances, hallucinations and tendon ruptures, particularly when those tendons are under stress. In addition, the family of drugs that includes Cipro, fluoroquinolones, is not recommended for use with children for fear that adverse effects related to joints and tendons may be more pronounced.

Overuse of Cipro also concerns Reinke from the perspective of antibiotic resistance.

"We're starting to have a huge problem with antibiotic resistance," Reinke said. "If people start stockpiling these drugs, this could only add to that problem. About half of the antibiotics prescribed in this country are prescribed without a really good reason, adding to the likelihood of resistance developing.

"Fluoroquinolones are extremely valuable drugs. They are one of the newest families of antibiotics that have become available. So far, in this country, resistance to these drugs has not become a problem. But because they are new, they are being prescribed probably more often than they should be and that could lead to a buildup of resistance."

Finally, Reinke said that, despite the media attention given to Cipro, there are other, more conventional antibiotics that likely would be just as effective against the strains of anthrax that have been detected so far.

"It's not accurate that Cipro is the only antibiotic that has been successful in treating anthrax," he said. "The reason that Cipro got all the media attention was because it's new and the initial fear was that the anthrax to which the victims had been exposed had been bioengineered to be resistant to other antibiotics. But the evidence seems to be that this particular strain has not been modified in any way, that it's a pretty low-level organism."

Reinke said other antibiotics that would likely be equally effective in the treatment of the anthrax strains discovered to date include penicillin and doxycycline.

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CONTACT: Reinke, 334/844-8348.