To prepare for a potential wide-scale anthrax attack, state and local health officials should determine how antibiotics should best be stored in their communities. One approach may be to dispense antibiotics to first responders, physicians and other health workers, said a Sept. 30 report by the Institute of Medicine. They would store antibiotics and distribute them to patients when appropriate. This strategy may be beneficial for those who cannot travel to distribution points to receive antibiotics because of a medical condition. Such prepositioning strategies may provide antibiotics more quickly and efficiently. Prepositioning refers to the storage of medical countermeasures, such as antibiotics, close to or in the possession of people who need rapid access. This could include local stockpiles, workplace caches and home storage. "Delivering antibiotics effectively following an anthrax attack is a tremendous public health challenge," said emergency physician Robert Bass, MD, chair of the committee that wrote the report and executive director of the Maryland Institute for Emergency Medical Services Systems. "The Strategic National Stockpile has ample supplies of the antibiotics. The issue is not whether inventory is adequate but how to get the medication into people's hands soon enough to be effective." Antibiotics are most effective in preventing anthrax-related illness or death if taken before symptoms occur, according to the report. Federal, state and local plans for dispensing antibiotics rely heavily on postattack delivery from state stockpiles or the Centers for Disease Control and Prevention's Strategic National Stockpile. This national repository of medicine and medical supplies is provided to the public primarily at points of distribution throughout each region. Prepositioning strategies would complement the Strategic National Stockpile plan, the report said ( But risks and benefits of the strategies should be accessed by each community. Dispensing antibiotics to people before an attack is one type of prepositioning strategy discussed in the report. But storing drugs at home could lead to inappropriate antibiotic use, including people taking antibiotics for unrelated conditions. Doctors should expect to be approached by patients who want early prescriptions for antibiotics, Dr. Bass said. Addressing patients on a case-by-case basis is key to determining whether to comply with their requests, he said. "Physicians certainly may see people who come to them and say, 'I'm concerned about the likelihood of an anthrax attack, and I'd like a prescription so I can keep antibiotics at home,' " he said. "It's important for physicians to educate patients on not taking antibiotics unless it's necessary." The full and original article can be found at: