Chief Executive Officers
Stuart B. Levy, President
Thomas F. O'Brien, Vice President
Kathleen T. Young, Executive Director
Board of Directors
Stuart B. Levy, Chairman
Harris A. Berman
Barbara Shattuck Dubow
Morton A. Madoff
Bonnie Marshall
Thomas F. O'Brien
Arnold G. Reinhold
Stephen C. Schoenbaum
Philip D. Walson
Scientific Advisory Board
Jacques F. Acar, France
Werner Arber, Switzerland
Fernando Baquero, Spain
Michael L. Bennish, USA
Patrice Courvalin, France
Jose Ramiro Cruz, Guatemala
Iwan Darmansjah, Indonesia
Julian Davies, Canada
Stanley Falkow, USA
Walter Gilbert, USA
Sherwood L. Gorbach, USA
Herman Goossens, Belgium
Ian M. Gould, Scotland
George Jacoby, USA
Ellen L. Koenig, USA
Calvin M. Kunin, USA
Yankel Kupersztoch, USA
Joshua Lederberg, USA
Stephen A. Lerner, USA
Donald E. Low, Canada
Richard P. Novick, USA
Jorge Olarte, Mexico
Maria Eugenia Pinto, Chile
Vidal Rodriguez-Lemoine, Venezuela
José Ignacio Santos, Mexico
Mervyn Shapiro, Israel
K. B. Sharma, India
Atef M. Shibl, Saudi Arabia
E.J. Threlfall, United Kingdom
Alexander Tomasz, USA
Thelma E. Tupasi, Philippines
Jos. W.M. van der Meer, The Netherlands
Anne K. Vidaver, USA
Fu Wang, China
Bernd Wiedemann, Germany
Headquarters
APUA
75 Kneeland Street
Boston, MA 02111
USA
Telephone: 617-636-0966
Fax: 617-636-3999
Email: APUA@tufts.edu
Website: www.APUA.org
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FOR IMMEDIATE RELEASE
CONTACT:
Barbara A. Souder, PhD, MPH
Director, Public Policy, Domestic Programs, and Public Relations
Kathleen T. Young
Executive Director
Alliance for the Prudent Use of Antibiotics (APUA)
75 Kneeland Street
Boston, MA 02111
Phone: 617-636-0966
Fax: 617-636-3999
http://www.apua.org
barbara.souder@tufts.edu
Misuse of Cipro Will Create another Major Public Health Crisis-Experts Say
Boston, MA -- October 18, 2001 -- In response to hundreds of false anthrax alarms reported by health officials here and wide-scale public requests for antibiotics, Massachusetts infectious disease experts are hammering home two messages to the public: Do not panic about anthrax and do not demand antibiotics against your physician's advice. As the FDA considers approving two additional antibiotics (penicillin and doxycycline) for anthrax, specialists at a conference, cosponsored by the Massachusetts Department of Public Health and the Alliance for the Prudent Use of Antibiotics (APUA), warned that individual stockpiling of antibiotics will accelerate another mounting national crisis, i.e. antibiotic resistance. Antibiotic resistance in certain organisms was already reaching crisis proportions prior to the new ciprofloxacin (Cipro) fad.
With patients demanding the antibiotics from reluctant physicians "just in case," there are now thousands of antibiotics just sitting in American households waiting to be used. "Without specific instructions," warns Dr. Stuart B. Levy, an international antibiotic resistance expert from Tufts University School of Medicine, "patients are likely to take the drug for a common illness, like a cold or cough, just in case it is anthrax. Also, individuals stockpiling ciprofloxacin will be tempted to use this important antibiotic in the absence of any bioterrorist event. This can create the perfect scenario for the emergence of bacterial resistance to the drug in harmful bacteria, which cause a number of critical diseases, including pneumonias, urinary tract infections, peritonitis, septicemias, and sexually transmitted diseases."
"Antibiotics are truly societal agents. Each individual dose affects the community. Unnecessary use by one person has a negative impact on the rest of society," says Dr. Levy, who founded APUA to warn against the dangers of antibiotic misuse. Referring to the new pressure to stockpile antibiotics in households, he said that "We are living through a natural experiment in evolution, the likes of which I never thought I would see in my lifetime, and we won't know the results until long after the anthrax scare has passed." He warned that inappropriate large-scale use will lead to the proliferation of strains of bacteria resistant to this critically important antibiotic.
The American Medical Association (AMA) is also concerned. In a recent "Message to Physicians," the AMA notes that "The more often an antibiotic is used, the greater the chance of resistance developing. This is particularly true if the antibiotic is used in a sporadic pattern of on-again off-again dosing."
So what should legitimately concerned citizens do? Dr. Levy advises that "It is far better to let public health authorities monitor the anthrax situation and authorize and dispense antibiotics as needed and not leave a decision of such great societal consequence to individual consumers. It is very important to stress to the patient the need to refrain from taking these stockpiled antibiotics for any reason until receiving a government bioterrorism alert."
One public health official, Dr. Alfred DeMaria, an Assistant Commissioner at the Massachusetts Department of Public Health (MDPH) suggests that "stockpiling of antibiotics is strongly discouraged because it could lead to inappropriate patient decisions to self medicate, incomplete courses of antibiotics that might select for resistant organisms, the eventual use of expired medications, and the depletion of national supplies for medically-indicated uses. Antibiotics should be selected according to the specific infection of concern." The Department advisory also notes that "Inappropriate use of antibiotics may result in serious adverse effects, including allergic reactions and interactions with other medications."
Public health groups like APUA, along with the Centers for Disease Control and World Health Organization, stress the general need to decrease antibiotic misuse in order to preserve the power of antibiotics for when they are truly needed; for example, bacterial infection diagnosed by a physician or a government notice of the need for anthrax treatment. Meanwhile, minimizing the buildup of antibiotic resistance in the community should be the goal.
For more information about antibiotics and antibiotic resistance, see the following websites:
APUA: http://www.apua.org;
CDC: http://www.cdc.gov;
The MA Department of Public Health: http://www.state.ma.us/dph/dphhome.htm;
Interview with Dr. Stuart B. Levy on Stockpiling Antibiotics: www.healthsci.tufts.edu/apua/News/articles/risksOfStockpiling.html;
AMA: http://www.ama-assn.org/;
ACP-ASIM: http://www.acponline.org/.
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