title: Field testing a head-of-household method to dispense antibiotics.
abstract: 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.
authors: US Centers for Disease Control and Prevention, San Francisco, California, USA. mga1@cdc.gov
authors: Mary
authors: M
authors: Agócs
authors: Shannon
authors: S
authors: Fitzgerald
authors: Steven
authors: S
authors: Alles
authors: Graham John
authors: GJ
authors: Sale
authors: Victor
authors: V
authors: Spain
authors: Edward
authors: E
authors: Jasper
authors: Thomas Lee
authors: TL
authors: Grace
authors: Esther
authors: E
authors: Chernak
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents