In the wake of recent bioterrorist attacks, anxieties about biological and chemical agents have increased dramatically. Physicians throughout the nation are encountering patients who are concerned about exposure and are seeking antibiotics to address the risks associated with agents such as anthrax.
To date, no person has been exposed to anthrax or other biological agents in Massachusetts. With this in mind, Brigham and Women’s Hospital has adopted an approach to care that is consistent with recommendations of the Boston Public Health Commission (BPHC) and the Centers for Disease Control (CDC).
The hospital does not recommend antibiotic prophylaxis without a documented exposure to a confirmed bioterrorist agent, such as anthrax. Unnecessary use of antibiotics can lead to drug resistant bacteria and antibiotics can have side effects themselves. Stockpiling antibiotics in case of future exposure also is strongly discouraged because it could lead to inappropriate patient decisions to self-medicate, the growth of antibiotic-resistant organisms, the eventual use of expired medications, and the depletion of supplies of antibiotics for medically indicated uses.
BWH is also following the BPHC guidelines that do not recommend obtaining nasal cultures for anthrax. Nasal culture is a relatively insensitive test and the interpretation of either a positive or negative result is difficult. People who present with symptoms of illness that may represent anthrax should be evaluated as usual.