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Clinical Issues in the Prophylaxis, Diagnosis, and Treatment of Anthrax

2002; Centers for Disease Control and Prevention; Volume: 8; Issue: 2 Linguagem: Inglês

10.3201/eid0802.01-0521

1080-6059

David M. Bell, Phyllis E. Kozarsky, David S. Stephens,

Bacillus and Francisella bacterial research

On November 18, 2001, a meeting was held at the Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, to discuss the prophylaxis, diagnosis, and treatment of anthrax.Participants included clinicians and health department personnel from areas where anthrax cases were identified, infectious disease experts, representatives of professional societies, and experts from federal agencies.A patient recovering from inhalational anthrax also described her illness.The following is a summary of the presentations and discussion. Prophylaxis 1Ciprofloxacin, doxycycline, and penicillin G procaine have been approved by the Food and Drug Administration (FDA) for prophylaxis of inhalational Bacillus anthracis infection, on the basis of efficacy data in monkeys and pharmacokinetic, pharmacodynamic, and safety considerations (1-3).During the recent bioterrorist attacks, interim CDC recommendations for anthrax prophylaxis include ciprofloxacin or doxycycline; amoxicillin (in three daily doses) is an option for children and pregnant or lactating women exposed to strains susceptible to penicillin (4-6), to avoid potential toxicity of quinolones and tetracyclines.Amoxicillin is not widely recommended as a firstline prophylactic agent, however, because of lack of FDA approval, lack of data regarding efficacy, and uncertainty about the drug's ability to