NYC health boss cautions on antibiotics

NEW YORK, Oct. 9 (UPI) -- New York City Health Commissioner Neil Cohen on Tuesday warned doctors against writing antibiotic prescriptions for healthy patients and against recommending the purchase of gas masks for those fearing bioterrorism.

Filling of those prescriptions not only depletes the supply of medicines for current patients, he said, but could lessen the drug's effectiveness in time of real need.

"We have a very active anthrax surveillance program in New York City in which we are monitoring any early warning signs which would suggest to us that there is any manifestation of illness or cluster of illnesses that could be related to bioterrorism," Cohen told reporters at City Hall, after Mayor Rudolph W. Giuliani delivered a financial plan update for the city.

Cohen said the process has been in place for "several years."

However, the city's top physician said that following the Sept. 11 World Trade Center attacks the health department has been telephoning hospitals on a daily basis and has sent "informational packets" to hospitals and emergency rooms.

"We're speaking to physicians throughout the city and we are confident that there is no evidence of bioterrorism in the city at this same time," he told reporters, adding, though, that "We are seeing increasingly that pharmacies are dispensing prescriptions for powerful antibiotics."

He said that is to address what he described as "the anxiety and fear the public has about possible exposure to bioterrorism and were hear to say very clearly that it foes not make good sense these are very powerful medications. They have side effects that cud be disruptive and uncomfortable."

Cohen said he sent a warning letter to physicians Thursday after reports of anthrax cases in Florida were first reported.

"We strongly recommend against prescribing prophylactic antibiotics and purchasing gas masks: Use of prophylactic antibiotics, in the absence of evidence of a bioterrorist attack is not without risk. Inappropriate use of antibiotics will lead to increased antibiotic resistance among microorganisms causing common bacterial infections (e.g., otitis media, pneumonia) and may result in serious adverse reactions," he said in the letter.

The city's chief physician listed reactions such as gastrointestinal ailments, allergic reactions and interactions with other medications.

"The New York City Department of Health also strongly recommends that physicians not prescribe antibiotics for their patients to stockpile for future use: Hoarding of antibiotics could lead to inappropriate patient decisions to self medicate, shorten regimens that might select for resistant organisms, the eventual use of expired medications, and to the depletion of national supplies for routine use," the letter said.

"Purchasing of gas masks for protection against biologic agents is strongly discouraged," Cohen said in the letter. "Unless a mask was worn all the time, which is clearly dangerous and impractical, it would not protect against covert release of biological agents, Moreover, masks need to be fitted properly; improper use of gas masks can cause serious injury or even death by suffocation, especially among persons with underlying heart or lung disease."