Cipro Sites Popped Up, Then Vanished

Within days of last fall’s anthrax scare, fly-by-night Web sites hawking the antibiotic Cipro sprang up over the Internet, exploiting the nation’s sudden--and justifiable--fear of bioterror, medical investigators reported recently.

Writing in the Sept. 13 American Journal of Medicine, researchers found 59 shady pharmacies that sold the potent and potentially dangerous antibiotic. Most of the virtual pharmacies, the study showed, did not require a prescription as mandated by federal law. “The American Medical Assn. considers this practice very dangerous because there is no doctor-patient relationship,” said Alexander Tsai, a member of the research team and a medical student at Case Western Reserve University in Cleveland.

For the handful of pharmacies that did require a prescription, Cipro purchasers needed only to fill out an online questionnaire and have a “virtual doctor” dispense the drugs, researchers said.

“We found that within two weeks of the first anthrax attack that a spate of these Web sites popped up,” Tsai added. “Having this high-profile event gave people the opportunity to show there was a lack of regulation in this area.”

Tsai worked with Dr. Ashwini Sehgal, a professor at Case’s medical school, and Dr. Peter Lurie, deputy director of Public Citizen’s Health Research Group, a consumer watchdog group.

The Food and Drug Administration recently chose not to issue guidelines requiring special labeling of drugs sold over the Internet. Critics have complained that prescriptions sold online leave patients vulnerable to powerful drugs, and that pharmacists cannot explain the dangers. With proper labeling, patients would be better informed, critics say.

Patients taking Cipro should be monitored by a doctor. Side effects can include heart damage, increased intracranial pressure and convulsions.

Web sites that provide prescriptions can join the National Assn. of Boards of Pharmacy, which requires virtual sellers to abide by inspection criteria and state-licensing requirements. None of the sites in the study had joined the program. “We analyzed them [the virtual pharmacies] and found they were of poor quality, had no safeguards and charged high prices,” Tsai said. Most of the sites charged a markup of 50% over the wholesale cost, the study found. Cipro is manufactured by the Bayer Corp., which was not the supplier of the Internet sites, and had reported difficulty ramping up production last year.

Anthrax attacks killed five people in the U.S. When the assaults stopped, the Cipro-selling sites vanished, Tsai added.

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Delthia Ricks writes for Newsday, a Tribune company.