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JEREMY JOHN LEE, PHARM.D., BCPS, is Clinical Pharmacy Specialist, Department of Pharmacy, Palomar Medical Center, Escondido, CA. SHANNON JOHN JOHNSON, PHARM.D., is Director of Pharmacy, Sharp Memorial Hospital, San Diego, CA. MICHAEL J. SOHMER, B.S.PHARM., FASCP, is Clinical Pharmacist and DMAT San Diego CA-4 Chief Pharmacist, San Diego Hospice and The Institute of Palliative Medicine, San Diego; at the time of writing he was System SNF Consultant Pharmacist and DMAT San Diego CA-4 Chief Pharmacist, Sharp HealthCare, Chula Vista, CA.

Address correspondence to Dr. Lee at the Department of Pharmacy, Palomar Medical Center, 555 East Valley Parkway, Escondido, CA 92009 (jeremy.lee{at}pph.org).

Purpose. The key elements required for the health-system pharmacist to prepare and implement a hospital-based mass prophylaxis distribution effort for hospital employees are described. Summary. A bioterrorist attack may involve multiple jurisdictions which would necessitate a regional response. Pharmacists should collaborate not only with colleagues in their immediate areas, but also with pharmacists and emergency-management planners in neighboring counties and jurisdictions. Pharmacists must also develop antibiotic drug selection protocols and define the quantity needed to maintain hospital operations after a bioterrorist attack. Once the desired antibiotics have been selected and the number of employees has been determined, along with the length of prophylaxis therapy, it should be determined how much money will be needed to purchase and store enough medications to meet the need. Next, provisions must be made to acquire and store the antibiotic cache, with attention paid to cache rotation and packaging and repackaging recommendations. A detailed procedure for the deployment of an antibiotic cache must be developed. This procedure should include job descriptions and job action sheets for deployment team members and plans for receiving and dispensing antibiotics from the Strategic National Stockpile. Once the employee prophylaxis procedure is developed, staff must be educated about it, and exercises should be conducted to identify possible weaknesses in the procedure. Conclusion. Health-system pharmacists should play an active role in designing and implementing an antibiotic prophylaxis plan for employees for a potential bioterrorist attack. Understanding and following procedures provided in the tool kit are critical to their successful readiness. Index terms: Antiinfective agents; Biological warfare; Disaster planning; Drugs; Guidelines; Hospitals; Personnel; Pharmacists, hospital