CLEVELAND Web sites selling the prescription-only medication ciprofloxacin (also known by its brand name Cipro) sprang up quickly following an anthrax outbreak in October 2001, according to a new study by researchers from the Case Western Reserve University (CWRU) School of Medicine. The study, published today in the American Journal of Medicine, also found that these Web sites provided poor quality information, had inadequate consumer safeguards, and charged high prices.

On Oct. 4, 2001, the U.S. Centers for Disease Control and Prevention reported the first case of an anthrax outbreak by mail. Immediately following the anthrax outbreak, numerous Web sites began selling ciprofloxacin, then the only U.S. Food and Drug Administration (FDA)-approved drug to treat anthrax exposure. The outbreak provided the research team with a unique opportunity to illustrate the general difficulties regulators have had with these so-called "Internet pharmacies" that sell prescription drugs directly to the general public.

The researchers compiled information on 59 Web sites selling ciprofloxacin without a prescription between Oct. 28 and Oct. 31, 2001. Twenty-three sites (39 percent) had been created during the two weeks following the Oct. 4, 2001 announcement of the anthrax outbreak. Within a month, 29 sites (49 percent) had discontinued ciprofloxacin sales.

"The host of Web sites we identified sprouted up within two weeks of the anthrax outbreak one outbreak immediately following the other," said Alexander Tsai, a fourth-year CWRU medical student in the Dual Degree Program in Medicine and Health Services Research. "These online sales of prescription-only medications clearly do not involve any meaningful medical assessment, which is necessary when prescribing a potentially dangerous antibiotic like ciprofloxacin."

Most state medical practice acts stipulate that a physician must examine a patient before prescribing a medication. However, none of th
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Contact: George Stamatis
gxs18@po.cwru.edu
216-368-3635
Case Western Reserve University
13-Sep-2002

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