Recommendations for Post-Exposure Prophylaxis for _B. anthracis_ in Florida
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These recommendations are based on the susceptibility pattern of the _B. anthracis_ isolate from the Florida inhalational anthrax case.
Adults
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Adult males & non-pregnant females (ages 18-65 yrs)
Ciprofloxacin 500 mg orally twice a day for 60 days
OR
Doxycycline 100 mg orally twice a day for 60 days
OR
Amoxicillin 500 mg orally 3 times a day for 60 days
*Drug-drug interactions and individual patient allergies should be considered when selecting an antibiotic for prophylaxis.
Pregnant adult females
Amoxicillin 500 mg orally 3 times a day for 60 days
* If allergic to amoxicillin or penicillin, consultation with a physician is required as ciprofloxacin or doxycycline may be indicated.
Adults age 65 yrs & over
Doxycycline 100 mg orally twice a day for 60 days
OR
Ciprofloxacin 500 mg orally twice a day for 60 days
OR
Amoxicillin 500 mg orally 3 times a day for 60 days
*Drug-drug interactions and individual patient allergies should be considered when selecting an antibiotic for prophylaxis.
** In older adults, the potential CNS side effects of ciprofloxacin should also be considered when selecting an antibiotic for prophylaxis.
Children
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Antibiotics for children are listed in order of preference:
Children 9 yrs & over
Amoxicillin 500 mg orally 3 times a day for 60 days
OR
Ciprofloxacin 500 mg orally twice a day for 60 days
OR
Doxycycline 100 mg orally twice a day for 60 days
*Drug-drug interactions and individual patient allergies should be considered when selecting an antibiotic for prophylaxis. Amoxicillin is preferred for children. If allergic to amoxicillin or penicillin, consultation with a physician is required, as ciprofloxacin or doxycycline may be indicated.
Children less than 9 yrs
Amoxicillin 80 mg/kg/day orally, divided into 3 doses a day for 60 days
OR
Ciprofloxacin 10-15 mg/kg/day orally, divided into 2 doses a day for 60 days
OR
Doxycycline 5 mg/kg/day orally, divided into 2 doses a day for 60 days
* Drug-drug interactions and individual patient allergies should be considered when selecting an antibiotic for prophylaxis. Amoxicillin is preferred for children. If allergic to amoxicillin or penicillin, consultation with a physician is required, as ciprofloxacin or doxycycline may be indicated.
* Reminder: symptoms of inhalational anthrax include fever, muscle aches, and fatigue that rapidly progress to severe systemic illness. Workers and visitors associate with the AMI worksite in Florida who develop such symptoms should be thoroughly evaluated to exclude anthrax and be reported to the state health department.
FOR ADDITIONAL INFORMATION
CALL CDC ATLANTA, USA
(404) 639-2807
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ProMED-mail
[This information is posted as a public service. Note all the warnings about drug interactions. Self-medication is *not* advisable. It is my understanding that tetracyclines and penicillin are effective for *treating* cutaneous anthrax. The CDC recommendations above are for *prophylaxis* against *airborne* anthrax in the environment. Anthrax is NOT transmitted person-to-person. - Mod.JW]
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I think we need to look at why the FDA has approved only Cipro. Certainly I would prefer amoxycillian, as it has been a proven antibiotic with few side-effects.
The last time I inquired the testing to see if one was truly allergic was expensive and not covered by insurance.
None of my three children have ever been given any penicillin or derivitives,as a precaution.
Maybe there are FReeper Docs or medical professinals who could address this.
mrs. meadsjn
I've taken Cipro in the past for a UTI. It's bad-a$$ stuff. It made me feel "disconnected", if that makes any sense. What I am trying to say is that the stuff has psycholocical side effects - at least it did with me.