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Stockpiling Drugs for an Avian Influenza Outbreak: Examining the Surge in Oseltamivir Prescriptions During Heightened Media Coverage of the Potential for a Worldwide Pandemic

Published online by Cambridge University Press:  02 January 2015

Leanne B. Gasink*
Affiliation:
Divisions of Infectious Diseases, University of Pennsylvania School of Medicine, Philadelphia Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia Center for Education and Research on Therapeutics, University of Pennsylvania School of Medicine, Philadelphia
Darren R. Linkin
Affiliation:
Divisions of Infectious Diseases, University of Pennsylvania School of Medicine, Philadelphia Department of Medicine, the Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia Center for Education and Research on Therapeutics, University of Pennsylvania School of Medicine, Philadelphia
Neil O. Fishman
Affiliation:
Divisions of Infectious Diseases, University of Pennsylvania School of Medicine, Philadelphia Center for Education and Research on Therapeutics, University of Pennsylvania School of Medicine, Philadelphia
Warren B. Bilker
Affiliation:
Department of Medicine, the Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia
Mark G. Weiner
Affiliation:
General Internal Medicine, University of Pennsylvania School of Medicine, Philadelphia
Ebbing Lautenbach
Affiliation:
Divisions of Infectious Diseases, University of Pennsylvania School of Medicine, Philadelphia Department of Medicine, the Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia Center for Education and Research on Therapeutics, University of Pennsylvania School of Medicine, Philadelphia
*
University of Pennsylvania, Ground Floor Penn Tower, Ste. 101, 33rd and Civic Center Boulevards, Philadelphia, PA 19104 ([email protected])

Abstract

Objective.

During fall 2005, personal stockpiling of oseltamivir for use during an outbreak of H5N1 influenza virus infection was widely reported. The present study aimed to identify indications for oseltamivir prescriptions to determine whether oseltamivir that was not intended for seasonal influenza was inappropriately consumed and to compare persons who were likely to have stockpiled oseltamivir and those who did not with respect to their knowledge, understanding, concerns, and expectations regarding avian influenza.

Design.

Survey to evaluate usage patterns for oseltamivir and assess views about avian influenza.

Subjects.

A total of 109 outpatients who received a prescription for oseltamivir between September 1, 2005, and December 31, 2005, and 825 matched control subjects.

Results.

Of 109 prescriptions, 36 (33.0%) were prescribed for patients with appropriate indications. Sixty-eight (62.4%) of 109 patients identified as having received oseltamivir and 440 (53.3%) of 825 individuals identified as not having received it responded to the questionnaire. Only 2 prescription recipients whose oseltamivir was not intended for immediate consumption reported that they had consumed the oseltamivir. Persons who probably intended to stockpile oseltamivir were older and more often white than those unlikely to stockpile it. They also reported greater worry about avian influenza and more often expected avian influenza to spread to the United States than those unlikely to stockpile, but there were no significant differences in responses to other questionnaire items.

Conclusions.

A large proportion of the oseltamivir prescriptions written in fall 2005 were probably intended for personal stockpiling. Similarities in participants' responses to questionnaire items suggest that educational campaigns may not be an effective method to curtail stockpiling of antimicrobial medications during an infectious threat. Promoting appropriate prescribing practices among providers may be a better means by which to minimize personal stockpiling.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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References

1.Brett, AS, Zuger, A. The run on Tamiflu—should physicians prescribe on demand? New Engl J Med 2005;353:26362637.Google Scholar
2.Ortiz, JR, Kamimoto, L, Aubert, RE, Yao, J, Epstein, RS. Out-of-influenza-season oseltamivir prescriptions, 2004 and 2005. In: Program and abstracts of the 44th Annual meeting of the Infectious Diseases Society of America (IDSA). Arlington, VA; IDSA, 2006.Google Scholar
3.Ortiz, JR, Shay, DK, Liedtke, LA, Bresee, JS, Strausbaugh, LI. A national survey of the Infectious Diseases Society of America Emerging Infections Network concerning neuraminidase inhibitor prescription practices and pandemic influenza preparations. Clin Infect Dis 2006;43:494497.Google Scholar
4.M'ikanatha, NM, Julian, KG, Kunselman, AR, Aber, RC, Rankin, JT, Lautenbach, E. Patients' request for and emergency physicians' prescription of antimicrobial prophylaxis for anthrax during the 2001 bioterrorism-related outbreak. BMC Public Health 2005;5:2.Google Scholar
5.Brinker, A, Pamer, C, Beitz, J. Changes in ciprofloxacin utilization as shown in a large pharmacy claims database: effects of proximity to criminal anthrax exposure in October 2001. J Am Pharm Assoc 2003;43:375378.CrossRefGoogle Scholar
6.Shaffer, D, Armstrong, G, Higgins, K, et al.Increased US prescription trends associated with the CDC Bacillus anthracis antimicrobial post-exposure prophylaxis campaign. Pharmacoepidemiol Drug Saf 2003;12:177182.CrossRefGoogle Scholar
7.Navas, E. Problems associated with potential massive use of antimicrobial agents as prophylaxis or therapy of a bioterrorist attack. Clin Microbiol Infect 2002;8:534539.Google Scholar
8.Ceaser, S, Wurtz, R. “Leftover” antibiotics in the medicine cabinet. Ann Intern Med 2000;133:74.CrossRefGoogle ScholarPubMed
9.Grigoryan, L, Haaijer-Rysjamp, FM, Burgerhof, JG, et al.Self-medication with antimicrobial drugs in Europe. Emerg Infect Dis 2006;12:452459Google Scholar
10.Richman, PB, Garra, G, Eskin, B, Nashed, AH, Cody, R. Oral antibiotic use without consulting a physician: a survey of ED patients. Am J Emerg Med 2001;19:5760.Google Scholar
11.World Health Organization. Avian influenza frequently asked questions. Available at: http://www.who.int/csr/disease/avian_influenza/avian_faqs/en/index.html#drugs2. Accessed June 6, 2007.Google Scholar
12.Taubenberger, JK, Morens, DM. 1918 Influenza: the mother of all pandemics. Emerg Infect Dis 2006;12:1522.Google Scholar