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As part of preparations for a possible large-scale anthrax attack, public health officials on the state and local levels should determine where and how anthrax-preventing antibiotics should be stored in their communities, says a new report from the Institute of Medicine. The report recommends that state, local, and tribal health officials work with the federal government to assess the benefits and costs of strategies that preposition antibiotics close to or in the hands of people who will need quick access to them should an attack occur. These locations include local stockpiles, workplace caches, or possibly homes. However, the report discourages broad use of a home storage strategy for the general population due to possible antibiotic misuse and higher costs.
If an anthrax attack occurred in a large city, hundreds of thousands of people could need rapid access to antibiotics to prevent possible illness or death. Delivering these antibiotics effectively after an attack is a public health challenge because of the large number of people who may be exposed and the brief window of time during which they would need to take the antibiotics.