Field testing a head-of-household method to dispense antibiotics.
OBJECTIVE
Using a simulated anthrax exposure scenario, the Philadelphia Department of Public Health tested how rapidly and accurately a head-of-household (HoH) point of dispensing (PoD) site with an express dispensing line could provide medication to heads of households collecting antibiotics for all household members.


METHODS
The 8 pretrained PoD leadership staff trained the other 42 PoD staff in the hour before the field trial. During the 2-hour field trial, proxy-HoHs used scripts with pertinent information describing household members to complete a HoH PoD intake form. PoD staff, 6 with medical training, used the form to direct HoHs to either express dispensing, where only adult dosing of ciprofloxacin was provided for each household member, or to screening, where targeted information was collected before antibiotics were dispensed.


RESULTS
In 2 hours, 717 individual HoHs picked up medication for a total of 2,120 household members (average household size = 2.96 persons) with a throughput rate of 1,060 person-medication doses dispensed per hour. Among 616 (86%) HoHs with a recorded PoD transit time, the 294 express-line-eligible HoHs passed through twice as fast as the 322 HoHs who required screening (medians = 3 versus 8 minutes, respectively, p < 0.01). Ninety-seven percent of people were accurately prescribed antibiotics.


CONCLUSIONS
HoH PoDs, using a limited number of medically trained staff, can rapidly and accurately provide medication to a large population. The express dispensing line speeded transit time without compromising medication dispensing accuracy. Dispensing medications to HoHs can be an accurate and effective way to reach large populations during a public health emergency.
Agócs
Mary
M
US Centers for Disease Control and Prevention, San Francisco, California, USA. mga1@cdc.gov
Fitzgerald
Shannon
S
Alles
Steven
S
Sale
Graham John
GJ
Spain
Victor
V
Jasper
Edward
E
Grace
Thomas Lee
TL
Chernak
Esther
E
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000600:supply & distribution*; D023482:Bioterrorism; D002648:Child; D004189:Disaster Planning; D017598:Efficiency, Organizational; D005191:Family Characteristics; D005260:Female; D006801:Humans; D008297:Male; D010593:Pharmaceutical Services / Q000458:organization & administration*; D015143:Philadelphia; D015397:Program Evaluation
D000900:Anti-Bacterial Agents