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Doxycycline becomes anthrax drug of choice in Washington

WASHINGTON (CNN) -- Washington health officials said they'll be giving people who need preventive treatment against anthrax the antibiotic doxycycline, rather than ciprofloxacin, known by the brand name Cipro.

"We'll be treating them with 60 days of doxycycline, which is what the CDC [Centers for Disease Control and Prevention] is now recommending because we are fortunate to have a very sensitive organism," said Dr. Gregory Martin, an infectious disease specialist at Bethesda Naval Medical Center in Maryland.

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More than 10,000 people in the Washington area are now on Cipro.

Authorities initially prescribed ciprofloxacin but now are prescribing doxycycline because the anthrax strain seen so far is sensitive to a wide range of antibiotics, and they said they wanted to bolster the public's confidence in other drugs.

"We have not put this many people on this number of concentrated antibiotics, if not ever, in certainly a long period of time," Dr. Ivan Walks, Washington's chief health officer, told CNN on Sunday.

The CDC has said almost from the beginning of the anthrax crisis that other antibiotics can be used for anthrax -- the switch now is aimed at achieving a better balance in the types of antibiotics used. Using a single antibiotic for extended periods of time can increase the likelihood of antibiotic resistance.

Cipro still will be used in the fight against anthrax.

The CDC said that side effects common to both ciprofloxacin and doxycycline include nausea, vomiting, diarrhea and sensitivity to the sun. Other ciprofloxacin side effects include headaches, dizziness or sun rash and may be accentuated by caffeine or theophylline-containing medications.

Other adverse side effects associated with doxycycline include dark "furry" tongue, black tongue or swollen tongue, or vaginal yeast infection. Serious side effects could include an allergic reaction, severe headaches, changes in vision, confusion, liver damage, blood problems or genital sores or itching.

Anthrax in a laboratory  

The Supreme Court justices began a 10-day doxycycline prophylactic treatment Friday, Walks said, after anthrax spores were found in an off-site mail room that serves the nation's highest court. The Washington health officials' endorsement of doxycycline may increase its use and give the public more confidence in the drug.

Walks also said that cost is not a factor since both drugs are "in the national stockpile."


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