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Posted on 10/08/2001 8:54:43 PM PDT by Brian Kopp DPM

Short version: Cipro 500 mg OR Doxycycline hyclate 100 mg every 12 hours prior to imminent biological attack-- simple important info

This information has been condensed from Treatment of Biological Warfare Agent Casualties, Headquarters Departments of The Army, The Navy and The Air Force and Commandant, Marine Corps

Washington, DC
17 July 2000
Field Manual No. 8-284
NAVMED P-5042
Air Force Manual (Interface) No. 44-156
Marine Corps MCRP 4-11.1C

Please see the website linked above for full information on detection, diagnosis, treatment, etc. I hope you find this helpful.
--Dr. Brian Kopp (proud2brc)

Anthrax, Plague and Tularemia are the only biological germ warfare agents for which pre-exposure prophylaxis (taking antibiotics before exposure to prevent infection) is available. Standard prophylaxis is:

Cipro 500 mg every 12 hours prior to imminent anthrax attack
OR Doxycycline hyclate 100 mg every 12 hours prior to imminent anthrax attack

Cipro is very expensive and much more likely to cause side effects. It cannot be used with children because it causes premature growth plate closure. Unless there are no alternatives and the child’s life is in danger, do not use Cipro in pediatric patients.

Darby Drug and other medical catalogues carry Doxycycline 100mg, quantity 500, for approximately $50, if you or a close friend or relative is a pharmacist or doctor or dentist who can order these drugs wholesale.

If 5 individuals are to be prophylaxed with Doxycycline, they will need 10 tabs per day. Optimally, prophylaxis should start 12 hours prior to imminent anthrax attack. Since there is obviously no way to predict if an when such attack is imminent, a prudent decision must be made as to which individuals are most at risk. Those individuals may need to take Doxycycline indefinitely. Thousands of teenagers take Doxycycline for extended periods for acne with few side effects, so there is no real fear of problems with chronic Doxycycline use.

Five individuals taking Doxycycline 100 mg twice daily for a month will require 300 tabs. At $50 per bottle of 500, this works out to $30 per month, or $6 per person per month, a reasonable investment if attack is truly a possibility.

For those allergic to Doxycycline, Cipro can be purchased for approximately $500 per 100 tablets. I would strongly recommend asking local physicians to donate samples, and a pharmacist may be able to purchase both Cipro and Doxycycline at far lower prices than those quoted here.

Most docs have samples of Cipro on their shelves, but they may not want to give it away at this point. It is the drug of choice as prophylaxis, they know that, and they will keep it for themselves and family and friends.

If you are concerned and want a prescription for Doxycycline, just ask your doctor for one. If they resist...play on their guilt:

"Oh c'mon, doc, I know you have cipro samples for yourself. The least you can do is write me an Rx to put my mind at ease. You know that Doxycycline is harmless, cheap, and a good prophylaxis for anthrax and plague. How about writing an Rx for me. I'll probably never take it, but it will at least let me sleep at night."

Any kind of doc can write for this, i.e., MD's, dentists (they prescribe it for gum disease all the time, they should have no problem Rx'ing this), podiatrists. Ask for a two month supply per person. That's equal to 120 Doxycycline 100 mg tablets per person. Don't take it unless you have good reason to believe there has been a release. But get the prescription filled so you have it on the shelf.

Anthrax

Pre-exposure Prophylaxis:
Cipro 500 mg every 12 hours prior to imminent anthrax attack
OR Doxycycline hyclate 100 mg every 12 hours prior to imminent anthrax attack.

Post-exposure Prophylaxis:
Use immunization with chemoprophylaxis to prevent the clinical manifestation of the disease. Chemoprophylaxis is recommended as an adjunct to immunization for post-exposure prophylaxis.

Cipro 500 mg every 12 hours for at least 4 weeks.
OR Doxycycline hyclate 100 mg every 12 hours for at least 4 weeks.

Plague

Pre-exposure Prophylaxis:
Cipro 500 mg every 12 hours prior to imminent anthrax attack
OR Doxycycline hyclate 100 mg every 12 hours prior to imminent anthrax attack; discontinue if the employment of plague BW can be excluded.

Post-exposure Prophylaxis:
Doxycycline 100 mg orally every 12 hours for one week or Cipro 500 mg orally every 12 hours for one week.

Tularemia

Pre-exposure Prophylaxis: Chemoprophylaxis given for anthrax or plague (ciprofloxacin, doxycycline) may confer protection against tularemia, based on in vitro susceptibilities.

Post-exposure Prophylaxis:
Doxycycline 100 mg orally every 12 hours for 2 weeks; or tetracycline 500 mg orally every 6 hours for 2 weeks; or
ciprofloxacin 500 mg orally every 12 hours for 2 weeks.
Melioidosis, Q Fever, Brucellosis, Glanders:
No antibiotic prophylaxis available

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