Disease
Bacillus anthracis is a pathogen that causes a life-threatening disease; anthrax. Causation is from the exposure to the spores of the bacteria, Bacillus anthracis that become entrenched in the host body and produce lethal poisons. Inactivation of Bacillus anthracis spores is important to ensure the environmental safety and public health.
Treatments
With early diagnosis, treatment and intensive support, including mechanical ventilation, fluids, and vasopressors, mortality rate may be reduced to less than the rate in previously documented cases (45% in the US 2001 anthrax attacks and 90% in cases before these attacks). If treatment is delayed (usually because of a missed diagnosis), death is likely.
Cutaneous anthrax without significant edema or systemic symptoms is treated with one of the following antibiotics:
Ciprofloxacin 500 mg (10 to 15 mg/kg for children) po q 12 h
Levofloxacin 500 mg po q 24 h
Doxycycline 100 mg (2.5 mg/kg for children) po q 12 h
Amoxicillin 500 mg po q 24 h
Cutaneous anthrax without significant edema, systemic symptoms, or risk of inhalation exposure is treated with antibiotics for 7 to 10 days. Treatment is extended to 60 days if concomitant inhalation exposure was possible.
Children and pregnant or breastfeeding women, who typically should not be given ciprofloxacin or doxycycline, should nonetheless be given one of these drugs; however, if prolonged treatment is needed, they may be switched to amoxicillin 500 mg (15 to 30 mg/kg for children) tid after 14 to 21 days if the organism is shown to be susceptible to penicillin. Mortality is rare with treatment, but the lesion will progress through the eschar phase.
Inhalation and other forms of anthrax, including cutaneous anthrax with significant edema or systemic symptoms, require therapy with 2 or 3 antibiotics. Antibiotic therapy should include ≥1 antibiotic with bactericidal activity, and ≥1 should be a protein synthesis inhibitor, which may block toxin production (eg, ciprofloxacin plus clindamycin).
Rifampin, although not a protein synthesis inhibitor, may be used in this capacity because it has a synergistic effect with the primary antibiotic.
Once IV combination therapy is completed, therapy should be switched to a single oral antibiotic.
The CDC say’s, “Anthrax is NOT contagious - You cannot catch anthrax from another person the way you might catch a cold or the flu. In rare cases, person-to-person transmission has been reported with cutaneous anthrax, where discharges from skin lesions might be infectious.”
Bacillus anthracis is a pathogen that causes a life-threatening disease; anthrax. Causation is from the exposure to the spores of the bacteria, Bacillus anthracis that become entrenched in the host body and produce lethal poisons. Inactivation of Bacillus anthracis spores is important to ensure the environmental safety and public health.
Treatments
With early diagnosis, treatment and intensive support, including mechanical ventilation, fluids, and vasopressors, mortality rate may be reduced to less than the rate in previously documented cases (45% in the US 2001 anthrax attacks and 90% in cases before these attacks). If treatment is delayed (usually because of a missed diagnosis), death is likely.
Cutaneous anthrax without significant edema or systemic symptoms is treated with one of the following antibiotics:
Ciprofloxacin 500 mg (10 to 15 mg/kg for children) po q 12 h
Levofloxacin 500 mg po q 24 h
Doxycycline 100 mg (2.5 mg/kg for children) po q 12 h
Amoxicillin 500 mg po q 24 h
Cutaneous anthrax without significant edema, systemic symptoms, or risk of inhalation exposure is treated with antibiotics for 7 to 10 days. Treatment is extended to 60 days if concomitant inhalation exposure was possible.
Children and pregnant or breastfeeding women, who typically should not be given ciprofloxacin or doxycycline, should nonetheless be given one of these drugs; however, if prolonged treatment is needed, they may be switched to amoxicillin 500 mg (15 to 30 mg/kg for children) tid after 14 to 21 days if the organism is shown to be susceptible to penicillin. Mortality is rare with treatment, but the lesion will progress through the eschar phase.
Inhalation and other forms of anthrax, including cutaneous anthrax with significant edema or systemic symptoms, require therapy with 2 or 3 antibiotics. Antibiotic therapy should include ≥1 antibiotic with bactericidal activity, and ≥1 should be a protein synthesis inhibitor, which may block toxin production (eg, ciprofloxacin plus clindamycin).
Rifampin, although not a protein synthesis inhibitor, may be used in this capacity because it has a synergistic effect with the primary antibiotic.
Once IV combination therapy is completed, therapy should be switched to a single oral antibiotic.
The CDC say’s, “Anthrax is NOT contagious - You cannot catch anthrax from another person the way you might catch a cold or the flu. In rare cases, person-to-person transmission has been reported with cutaneous anthrax, where discharges from skin lesions might be infectious.”