[Ip-health] Cipro vs. penicillin vs. doxy

[Peter Lurie]

It is, of course, a fair point that the sample sizes in the study were =
small (though not so small that all three of these drugs could not be =
shown better than placebo).  Unfortunately, if studies are done in =
expensive animals like rhesus monkeys, the sample sizes very often are =
small, such as the ten in each group in this case.  And while it is true =
that cipro, pen and doxy have efficacies that are statistically indistingui=
shable from one another, it remains true that the best estimate of the =
efficacy of the drugs is that measured in the trial (1 death for cipro and =
doxy; 3 for pen).  And there are no other data.  Remember, too, that all =
strains so far recovered have been susceptible to all drugs.
It is also true, as Khalil points out, that cipro is the only one with FDA =
approval for post-exposure prophylaxis for anthrax.  But that is because =
the FDA only approached Bayer, not other manufacturers.  This is probably =
because the other two drugs are generic and thus the economic incentive to =
seek approval for this indication was not there for those drugs.  Despite =
all the criticism Bayer is receiving, this has paid off very handsomely =
for them.
Peter

Peter Lurie, MD, MPH
Deputy Director
Public Citizen's Health Research Group
1600 20th Street, NW
Washington, DC 20009
Phone: (202)588-7781
Fax: (202)588-7796
Email: plurie@citizen.org
Web address: http://www.citizen.org