TY - JOUR AU - Moodie, Claire E. AU - Thompson, Herbert A. AU - Meltzer, Martin I. AU - Swerdlow, David L. T1 - Prophylaxis after Exposure to Coxiella burnetii T2 - Emerging Infectious Disease journal PY - 2008 VL - 14 IS - 10 SP - 1558 SN - 1080-6059 AB - Coxiella burnetii is a category B bioterrorism agent. We numerically evaluated the risks and benefits from postexposure prophylaxis (PEP) after an intentional release of C. burnetii to the general population, pregnant women, and other high-risk populations. For each group, we constructed a decision tree to estimate illness and deaths averted by use of PEP/100,000 population. We calculated the threshold points at which the number of PEP-related adverse events was equal to the cases averted. PEP was defined as doxycycline (100 mg 2×/day for 5 days), except for pregnant women, where we assumed a PEP of trimethoprim-sulfamethoxazole (160 mg/800 mg 2×/day) for the duration of the pregnancy. PEP would begin 8–12 days postexposure. On the basis of upper-bound probability estimates of PEP-related adverse events for doxycycline, we concluded that the risk for Q fever illness outweighs the risk for antimicrobial drug–related adverse events when the probability of C. burnetii exposure is >7% (pregnant women using trimethoprim-sulfamethoxazole = 16%). KW - Coxiella burnetti KW - Q fever KW - prophylaxis KW - risk-benefit assessment KW - pregnant women KW - research DO - 10.3201/eid1410.080576 UR - https://wwwnc.cdc.gov/eid/article/14/10/08-0576_article ER - End of Reference