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Risk Management Alerts
CMA BIOTERRORISM ACTION UPDATE-ADVICE FOR PATIENTS, INFORMATION FOR PHYSICIANS
From CMA Alert October 18. 2001
(Used with permission)
To help calm Californians' anxiety over anthrax and the prospect of bioterrorist acts spreading to California, CMA today issued a letter that physicians can have in their offices for patients who inquire about obtaining antibiotics to "have on hand" or use prophylactically. The letter succinctly advises of the dangers of unnecessary antibiotic
use.
BIOTERRORISM AND ANTIBIOTICS
WHAT YOU SHOULD KNOW
Dear Patient:
Because of the terrible events of September 11 th and the latest cases of anthrax, many
patients have expressed concern about bioterrorism. Patients have asked whether they
should be taking antibiotics now as a preventive measure to protect themselves against
such diseases.
Please be aware that infectious disease experts at the nation's leading public health
agency, Centers for Disease Control and Prevention (CDC), recommend that
physicians NOT prescribe antibiotics as a preventive measure or so patients can
stockpile these medicines. There are extremely compelling reasons for this advice.
1. The CDC and other state and local health care agencies are working in a concerted
way to detect, diagnose, respond to and prevent illnesses caused by bioterrorism. The
CDC has an ample supply of medications and they are prepared to reach the public within
hours of the event. This plan was implemented at the time of the September 11 th attack
and worked extremely well.
2. Many biological or chemical agents could be used in a bioterrorism attack. Therefore,
the course of treatment will be different and specific to each agent. Anticipating which
medications to keep on hand is therefore practically impossible.
3. Unnecessary use of antibiotics is not recommended because there are serious side
effects. Many antibiotics are absolutely not to be taken by children, teens and pregnant
or nursing women. Such use also diminishes existing supplies of antibiotics that will be
needed if there is widespread infection or to treat other infectious diseases.
4. Most crucial, overuse and misuse of antibiotics through self-medication can create
bacteria resistant to treatment. So, when you get sick and need the medicine, it may not
work. Antibiotic use must be necessary and specific.
Specifically Regarding Anthrax: Anthrax is an infectious disease but it is not contagious; it cannot be spread from one human to another.
Symptoms: Symptoms vary but occur within 7 days after exposure. Initial symptoms of
"inhalation" anthrax may resemble influenza and progress to severe breathing problems.
"Intestinal" anthrax may cause nausea, vomiting, abdominal pain and fever. "Cutaneous"
anthrax, the type that we've seen on the East Coast, appears on the skin with recognizable
lesions identifiable by a physician.
Treatments: The antibiotic Cipro is currently the most publicized antibiotic used to treat
persons exposed to anthrax, but the FDA has approved three types antibiotics for
treatment of Anthrax: ciproflaxins, penicillins and tetracyclines (including doxycycline).
Officials are treating people who have been in or near anthrax-exposed areas with
antibiotics and are successfully preventing progression of the disease.
For more information, please refer to the following websites:
CDC Bioterrorism website:
www.bt.cdc.gov
Department of Health Services: Q & A on Anthrax prevention and treatment
www.hhs.gov/news/press/2001pres/20011010a.html
California Department of Health Services, Division of Communicable Disease Control:
www.dhs.ca.gov/ps/dcdc/bt/index.htm
Alliance Working for Antibiotic Resistance Education (AWARE):
www.aware.md
Trust your physician: Your personal physician is your first line of defense when you
have any questions or concerns about your health. If medications are necessary, your
physician will prescribe the most effective treatment needed to keep you and your family
well. In these times, it is important to remain calm. Please know that I will be on the
front lines with the California Medical Association to identify, treat and respond to any
emerging diseases. If you suspect a problem, please call my office.
Sincerely,
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