title: Patients' request for and emergency physicians' prescription of antimicrobial prophylaxis for anthrax during the 2001 bioterrorism-related outbreak.
abstract: BACKGROUND
  Inappropriate use of antibiotics by individuals worried about biological agent exposures during bioterrorism events is an important public health concern. However, little is documented about the extent to which individuals with self-identified risk of anthrax exposure approached physicians for antimicrobial prophylaxis during the 2001 bioterrorism attacks in the United States.
  
  
  METHODS
  We conducted a telephone survey of randomly selected members of the Pennsylvania Chapter of the American College of Emergency Physicians to assess patients' request for and emergency physicians' prescription of antimicrobial agents during the 2001 anthrax attacks.
  
  
  RESULTS
  Ninety-seven physicians completed the survey. Sixty-four (66%) respondents had received requests from patients for anthrax prophylaxis; 16 (25%) of these physicians prescribed antibiotics to a total of 23 patients. Ten physicians prescribed ciprofloxacin while 8 physicians prescribed doxycycline.
  
  
  CONCLUSIONS
  During the 2001 bioterrorist attacks, the majority of the emergency physicians we surveyed encountered patients who requested anthrax prophylaxis. Public fears may lead to a high demand for antibiotic prophylaxis during bioterrorism events. Elucidation of the relationship between public health response to outbreaks and outcomes would yield insights to ease burden on frontline clinicians and guide strategies to control inappropriate antibiotic allocation during bioterrorist events.
authors.affiliation: Division of Infectious Disease Epidemiology, Pennsylvania Department of Health, Harrisburg, PA, USA. nmikanatha@state.pa.us
authors.forename: Nkuchia M
authors.initials: NM
authors.lastname: M'ikanatha
authors.forename: Kathleen G
authors.initials: KG
authors.lastname: Julian
authors.forename: Allen R
authors.initials: AR
authors.lastname: Kunselman
authors.forename: Robert C
authors.initials: RC
authors.lastname: Aber
authors.forename: James T
authors.initials: JT
authors.lastname: Rankin
authors.forename: Ebbing
authors.initials: E
authors.lastname: Lautenbach
mesh_terms: D000881:Anthrax / Q000517:prevention & control*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D023482:Bioterrorism; D002939:Ciprofloxacin / Q000627:therapeutic use; D004318:Doxycycline / Q000627:therapeutic use; D004363:Drug Utilization / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010414:Pennsylvania; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D004318:Doxycycline