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- Treat mild cutaneous anthrax with oral antibiotics.
- Treat inhalational anthrax, anthrax meningitis, GI anthrax, and severe cutaneous disease with two or three intravenous antibiotics.
| | Drug Treatment for Anthrax (table)
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Treat mild cutaneous anthrax with oral antibiotics.  |
- In patients with no signs of systemic disease (fever, chills, shortness of breath, positive blood culture result), treat naturally occurring cutaneous anthrax on the extremities with oral ciprofloxacin, doxycycline, or penicillin (once antimicrobial susceptibility testing demonstrates susceptibility to penicillin) for 7 to 10 days.
- Treat patients with uncomplicated cutaneous anthrax associated with a bioterrorist attack with oral antibiotics for 60 days, and once the patient has improved, consider administering the anthrax vaccine (see section on Prevention).
- Treat patients with signs and symptoms of systemic disease, such as fever, dyspnea, or nuchal rigidity, or with cutaneous anthrax on the face or neck with two or three intravenous antibiotics.
- See table Drug Treatment for Anthrax.
| Background | Back to top
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Treat inhalational anthrax, anthrax meningitis, GI anthrax, and severe cutaneous disease with two or three intravenous antibiotics.  |
- Treat inhalational anthrax, anthrax meningitis, GI anthrax, and severe cutaneous disease with intravenous ciprofloxacin (preferred) or doxycycline.
- Add at least one or two additional antibiotics with adequate CNS penetration and in vitro activity against B. anthracis, such as rifampin, vancomycin, penicillin or ampicillin, and meropenem.
- Include clindamycin in the treatment regimen.
- Tailor antibiotic therapy to the susceptibility of the isolate as soon as it is known.
- Treat pregnant women and children with a similar regimen.
- In patients with severe systemic illness, consider the use of anthrax immune globulin or other anti-anthrax immunotherapeutics, which are available from the CDC under an investigational new drug protocol.
- Treat inhalational anthrax, anthrax meningitis, GI anthrax, and severe cutaneous disease for 60 days, and then switch to oral antibiotic therapy when the patient shows clinical improvement.
- Consider vaccinating patients treated for inhalational anthrax, anthrax meningitis, GI anthrax, and severe cutaneous disease with anthrax vaccine, but be prepared for the increased likelihood of a severe local reaction.
- Do not delay treatment of suspected inhalational anthrax, anthrax meningitis, GI anthrax, and severe cutaneous disease in persons in a high-risk group during a bioterrorist attack.
- See table Drug Treatment for Anthrax.
| Background | Back to top
| | | FAQs |
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| Barbara Robinson-Dunn, PhD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Nicholas John Vietri, MD, MS, editorial consultant, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Niklas Mackler, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Sandro Cinti, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Deborah Korenstein, MD, FACP, Co-Editor, PIER, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Richard B. Lynn, MD, FACP, Co-Editor, PIER, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. |
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Anthrax
