Drug of the Moment: Cipro

At first glance it looks like the greatest marketing coup of all time: In the midst of escalating public anxiety about anthrax, one pharmaceutical company looks set to rake in huge profits from its superstar antibiotic, Cipro, which also happens to be the only FDA-approved treatment for inhalational anthrax.

Exactly what those profits will be remains a matter of speculation. Bayer’s stock price has not shown any dramatic response to the anthrax scares. The company is quick to dispel such speculation: Wednesday morning, Bayer’s French division angrily denied accusations that the company is profiteering from the anthrax scare. "We are scandalized and outraged by this accusation," a spokesperson said. She went on to explain that while prices on the drugs have gone up somewhat in the past several weeks, that increase was only to cover the costs of newly frenetic manufacturing and shipping. (Bayer has tripled its production of the drug, promising the government it will deliver 200 million Cipro tablets in the next three months.)

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This is not a one-horse field; there are other antibiotics perfectly capable of treating anthrax, including various members of the penicillin and tetracycline classes. So how did Cipro, identified in the press as the weapon of choice in the war against anthrax, claim such a visible, and valuable, spot in the public consciousness?

Cipro, or ciprofloxacin HCl, is an oral antibiotic that was, until recently, used primarily to combat urinary tract infections. In the summer of 2000, after hearing testimony on bioterrorist threats, rattled lawmakers launched an investigation into U.S. preparedness. They found two drugs were considered feasible treatments for anthrax: Penicillin and doxycycline. And they found problems with both. Scientists fear that introducing massive amounts of penicillin into the general population could hasten the creation of mutant penicillin-resistant strains of bacteria. Likewise, there was some evidence that terrorists had engineered strains of the anthrax bacteria resistant to both penicillin and doxycylcines. There was another option, lawmakers were told: Cipro.

Bayer was notified, and members of Congress urged the Food and Drug Administration to speed up the often labored process of drug approval. In August 2000, Cipro, which had demonstrated an anti-anthrax efficacy in tests on monkeys, was rushed through the approval process and dubbed the unequivocal drug of choice in the anthrax battle. It is currently the only drug used to treat inhalational (pulmonary) anthrax.

Bayer has patent rights over Cipro for at least another year — although those rights may now be challenged. Tuesday, U.S. Senator Chuck Schumer of New York announced there is a section of federal law allowing the government to buy generic versions of patented drugs. If his proposal is approved, Schumer says, the public would not have to worry about buying Cipro, because the government would have a supply large enough to go around.

Health and government officials, alarmed by recent stockpiling of the drug, eagerly point out that exposure to anthrax is still contained to an infinitesimal portion of the population. They also warn there are dangers to self-medication, ranging from common side effects like nausea to the worst-case scenario: Overuse of the drug could produce Cipro-resistant bacteria.