Donald A. Locasto knows people are scared about a massive outbreak of inhaled anthrax and a shortage of Cipro to treat it. “We shouldn't be,” he says.

        The odds of an outbreak in Cincinnati are almost nil, and there's plenty of Cipro and other antibiotics to treat it, says Dr. Locasto, an assistant professor of emergency medicine at the University of Cincinnati.

        As part of the Metropolitan Medical Response System, a federally-funded disaster-preparedness initiative, Cincinnati-area health agencies have stock piled Cipro and the cheaper tetracycline antibiotic, doxycycline, Dr. Locasto says.

        Both are effective against anthrax.

        He won't divulge details like how much is stockpiled or where it is. The local stockpile includes more doxycycline.

        “When your chances of ever using it are slim to none, you want to spend the money on an equally effective but cheaper medication,” Dr. Locasto says.

        Last week, the Centers for Disease Control and Prevention issued a list of antibiotics to be used in conjunction with Cipro and doxycycline in the event of more cases of inhaled anthrax.

        “If push did come to shove and there was a significant release in the area, I don't think we would run short of medicine,” Dr. Locasto says. “But the chances of seeing any kind of large-scale release of anthrax are almost zero. If you're not Senator Daschle's secretary or Tom Brokaw's aide, your chances of coming in contact with anthrax are small.”

        Other antibiotics in the same chemical class as Cipro are also believed to be effective against anthrax, says pharmacist Tom Imhoff, safety and clinical effectiveness officer for Trihealth. But the disease is so rare, the drugs have never been used to treat it.

        As Americans pester their physicians for Cipro prescriptions “just in case,” some experts are worried about antibiotic resistance.

        Several common infections are already resistant to workhorse antibiotics, Mr. Imhoff says. If Americans start popping Cipro like aspirin because of the anthrax scare, the antibiotic will be come less effective against the everyday ailments it's routinely used for.

        “The reason we encourage people to not routinely take it is it would increase the amount of resistance in the world if everyone was on it,” Mr. Imhoff says.

        Cipro also has side effects that can be troublesome, including insomnia, jitteriness, tremors and seizures. Less commonly, it can cause weakening and ruptures of tendons.

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