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Anthrax
Anthrax
Treatment
Acute
»
Although quinolone therapy is not generally
recommended for pregnant patients, current
recommendations support the use of
ciprofloxacin for severe cutaneous anthrax,
inhalation anthrax, or ingestion anthrax until
antibiotic susceptibilities are available.
[34]
If
B
anthracis
is sensitive, penicillin is the preferred
therapeutic agent. If antibiotic sensitivities,
exhaustion of supplies, or adverse reactions
preclude the use of ciprofloxacin in a pregnant
patient, doxycycline may be used as part of
combination therapy for inhalation anthrax. Risks
of doxycycline use (i.e., fetal toxicity and growth
retardation) must be weighed with the benefits of
therapy.
[34]
plus
switch to oral antibiotic therapy
Primary options
» ciprofloxacin
: 500 mg orally twice daily
OR
» moxifloxacin
: 400 mg orally once daily
OR
» levofloxacin
: 750 mg orally once daily
OR
» doxycycline
: 100 mg orally twice daily
OR
» amoxicillin
: 1000 mg orally three times daily
Secondary options
» clindamycin
: 600 mg orally three times daily
»
Patients may be switched to single-agent oral
therapy once they have completed 2 weeks of
intravenous therapy and shown a significant
clinical response.
»
Amoxicillin should only be used if
B anthracis
is sensitive to penicillin.
»
Total duration of therapy for a severe infection
is 60 days.
[34]
adjunct
antitoxin
Primary options
TR
E
AT
M
E
N
T
This PDF of the BMJ Best Practice topic is based on the web version that was last updated: Aug 08, 2018.
BMJ Best Practice topics are regularly updated and the most recent version
of the topics can be found on bestpractice.bmj.com . Use of this content is
subject to our disclaimer. © BMJ Publishing Group Ltd 2018. All rights reserved.
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