Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 26, Number 12—December 2020
Synopsis

Control and Prevention of Anthrax, Texas, USA, 2019

Tom Sidwa, Johanna S. Salzer, Rita Traxler, Erin Swaney, Marcus L. Sims, Pam Bradshaw, Briana J. O’Sullivan, Kathy Parker, Kenneth A. Waldrup, William A. Bower, and Kate HendricksComments to Author 
Author affiliations: Texas Department of State Health Services, Austin, Texas, USA (T. Sidwa, E. Swaney, B.J. O’Sullivan, K. Parker); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (J.S. Salzer, R. Traxler, W.A. Bower, K. Hendricks); Shannon Health System, Ozona, Texas, USA (M.L. Sims); Shannon Medical Center, San Angelo, Texas, USA (P. Bradshaw); Texas Department of State Health Services, El Paso, Texas, USA (K.A. Waldrup)

Main Article

Table 1

Oral antimicrobial drugss for postexposure prophylaxis and treatment of localized cutaneous anthrax*

Postexposure prophylaxis alone or after oral or intravenous therapy Monotherapy for localized cutaneous anthrax
Antimicrobial drugs before susceptibility testing For all strains, regardless of penicillin susceptibility
or if susceptibility is unknown
Ciprofloxacin 500 mg every 12 h Ciprofloxacin 500 mg every 12 h
OR OR
Doxycycline 100 mg every 12 h Doxycycline 100 mg every 12 h
OR OR
Levofloxacin 750 mg every 24 h Levofloxacin 750 mg every 24 h
OR OR
Moxifloxacin 400 mg every 24 h Moxifloxacin 400 mg every 24 h
OR OR
Clindamycin† 600 mg every 8 h Clindamycin† 600 mg every 8 h
OR OR
For penicillin-susceptible strains For penicillin-susceptible strains
Amoxicillin 1 g every 8 h Amoxicillin 1 g every 8 h
OR OR
Penicillin VK 500 mg every 6 h
Penicillin VK 500 mg every 6 h
Because patients who have had aerosol exposures might still have residual spores in their lungs even after treatment, oral postexposure prophylaxis is recommended as follows: for noncases (i.e., no treatment) without AVA, 60 d; with AVA for healthy adults 18–65 y, 14 d after the 3rd dose of AVA; with AVA for children <18 y, adults >65 y, pregnant women, and adults with underlying conditions, 60 d. For cases (i.e., following treatment) after finishing oral or intravenous treatment, patients exposed to aerosolized spores should finish out a 60-d course of antimicrobials (i.e., 60 d minus the duration of treatment) Duration of therapy for naturally acquired cases, 7 d

*Bold type indicates preferred agent. Nonbolded type indicates alternative selections, which are listed in order of preference for therapy for patients who cannot tolerate first-line therapy or if first-line therapy is unavailable.
†Based on in vitro susceptibility data, rather than studies of clinical efficacy.

Main Article

Page created: November 12, 2020
Page updated: November 19, 2020
Page reviewed: November 19, 2020
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external