Anthrax Treatment Acute treatment as soon as possible in patients where
there is a high level of clinical suspicion for
systemic anthrax. There are no data to suggest
that one antitoxin is better than another.
[60]
»
Raxibacumab and obiltoxaximab, monoclonal
antibodies directed against
Bacillus anthracis protective antigen, are both approved by the
US Food and Drug Administration (FDA) for
the treatment of inhalation anthrax. While there
is a lack of human data, these agents have
been found to be effective in animal studies.
[62]
[63]
A systematic review found that adjunctive
treatment with these agents may play a role
in enhancing survival, particularly in patients
for whom antimicrobial therapy alone does not
work.
[64]
Supplies of these drugs are held in the
national stockpile in the US for use by the CDC
in the event of an emergency.
»
The FDA has also approved anthrax
immunoglobulin for the treatment of inhalation
anthrax in combination with appropriate
antibiotics.
[65]
adjunct fluid drainage + supportive care »
Any patient with inhalation or ingestion anthrax
should be evaluated for pleural effusions and
ascites. If either of these fluid collections are
present, drainage of the fluid is recommended.
If re-accumulation of the fluid occurs, repeat
drainage is recommended.
»
Mechanical ventilation, haemodynamic
support, and adjunctive corticosteroid therapy
may be recommended depending on the clinical
presentation.
[60]
anthrax meningitis 1st empiric intravenous antibiotic therapy Primary options » ciprofloxacin
: 400 mg intravenously every 8
hours
--AND-- » meropenem
: 2 g intravenously every 8
hours