title: Changes in ciprofloxacin utilization as shown in a large pharmacy claims database: effects of proximity to criminal anthrax exposure in October 2001.
abstract: OBJECTIVE
  Identify, during the period of criminal anthrax exposures in October 2001, changes in utilization of ciprofloxacin and geographic patterns of any identified variations.
  
  
  METHODS
  Observational.
  
  
  METHODS
  United States.
  
  
  METHODS
  Individuals making prescription claims through a pharmacy benefits management company.
  
  
  METHODS
  Analysis of AdvancePCS pharmacy claims database.
  
  
  METHODS
  Percentage change in ciprofloxacin utilization for 2000 and 2001 and, by locale, for September and October 2001.
  
  
  RESULTS
  Utilization of ciprofloxacin tablets was significantly lower in calendar year 2001 than in calendar year 2000 (median decline, 10.3%) for all months except October, when utilization of ciprofloxacin increased 9.8%. During the period of anthrax exposures (October 2001 versus September 2001), affected geographic areas, including New York (an increase of 62.5%), some other Mid-Atlantic states, and Florida (28.5%), had some of the highest percentage increases in the rate of ciprofloxacin utilization.
  
  
  CONCLUSIONS
  Many Americans actively sought prophylaxis with ciprofloxacin during the course of the October 2001 anthrax attack and that utilization was higher in, but not limited to, locales with publicized cases of disease. Pharmacists, clinicians, and public health officials should note that such behavior may be expected in the event of a similar attack and should be familiar with current recommendations for the assessment and management of anthrax exposure.
authors.affiliation: Division of Drug Risk Evaluation, Office of Drug Safety, Center for Drug Evaluation and Research, Food and Drug Administration, Rockville, MD 20857, USA. brinkera@cder.fda.gov
authors.forename: Allen
authors.initials: A
authors.lastname: Brinker
authors.forename: Carol
authors.initials: C
authors.lastname: Pamer
authors.forename: Julie
authors.initials: J
authors.lastname: Beitz
mesh_terms: D000704:Analysis of Variance; D000881:Anthrax / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D023482:Bioterrorism; D002487:Centers for Disease Control and Prevention, U.S. / Q000592:standards; D002939:Ciprofloxacin / Q000627:therapeutic use*; D003415:Crime; D016208:Databases, Factual; D017723:Drug Utilization Review / Q000639:trends*; D004781:Environmental Exposure / Q000009:adverse effects; D006801:Humans; D014481:United States; D014486:United States Food and Drug Administration / Q000592:standards
chemical_list: D000890:Anti-Infective Agents; D002939:Ciprofloxacin