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- Administer a preexposure vaccination to persons at high risk of work exposure.
- Administer postexposure antibiotic prophylaxis and vaccine to persons who have been exposed to anthrax during a biological attack.
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Administer a preexposure vaccination to persons at high risk of work exposure.  |
- Administer preexposure vaccination to:
- Persons working with concentrated quantities of B. anthracis and those involved with activities with a high potential for aerosolization
- Persons working with imported hides, furs, bone meal, wool, or animal hair in settings where workplace standards and restrictions are not adequate to prevent exposure to anthrax spores
- Military personnel if exposure to a biological attack is likely
- Administer 0.5 mL of AVA, an inactivated cell-free product, intramuscularly at 0 and 4 weeks with boosters at 6, 12, and 18 months and then once every year thereafter.
- Counsel vaccinated persons on safety, side effects, and contraindications to the use of the anthrax vaccine as discussed on the CDC anthrax Web site.
- Vaccinate pregnant women against anthrax only if the potential benefits of vaccination outweigh potential risks to the fetus.
- Note that contraindications to the anthrax vaccine include a history of anthrax infection and anaphylaxis to a previous dose of anthrax vaccine.
| Background | Back to top
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Administer postexposure antibiotic prophylaxis and vaccine to persons who have been exposed to anthrax during a biological attack.  |
- Administer postexposure antibiotic prophylaxis to persons with a known exposure to anthrax or who are in a high-risk group for exposure during a biological attack with B. anthracis.
- Administer oral ciprofloxacin, doxycycline, or levofloxacin for postexposure prophylaxis during a biological attack.
- Consider amoxicillin for postexposure prophylaxis once the B. anthracis strain has been shown to be susceptible to amoxicillin.
- Confirm the antibiotic susceptibility pattern of the B. anthracis strain used in the biological attack, and tailor the antibiotic used for postexposure prophylaxis appropriately.
- Administer antibiotics for at least 60 days.
- If available, administer 0.5 mL of AVA subcutaneously at 0, 14, and 28 days to all patients receiving postexposure antibiotic prophylaxis.
- Monitor patients for side effects to antibiotics and vaccine.
- See table Drug Treatment for Anthrax.
| Background | Back to top
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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
