Infection: Anthrax

Question 1

Inhalation or gastro-intestinal anthrax should be treated initially with either ________ or in patients over 12 years, doxycycline [unlicensed indication] combined with one or two other antibacterials (such as _________, benzylpenicillin sodium, chloramphenicol, clarithromycin, clindamycin, imipenem wth _______, rifampicin [unlicensed indication] and vancomycin).

Answer 1

Inhalation or gastro-intestinal anthrax should be treated initially with either ciprofloxacin or, in patients over 12 years, doxycycline [unlicensed indication] combined with one or two other antibacterials (such as amoxicillin, benzylpenicillin sodium, chloramphenicol, clarithromycin, clindamycin, imipenem with cilastatin, rifampicin [unlicensed indication], and vancomycin).

Question 2

When the condition improves and the sensitivity of the Bacillus anthracis strain is know, treatment should be switched to a single antibacterial. Treatment should continue for __ days because germination may be delayed.

Answer 2

60

Question 3

Cutaneous anthrax should be treated with either ciprofloxacin [unlicensed indication] or which tetracycline for how many days?

Answer 3

Cutaneous anthrax should be treated with either ciprofloxacin [unlicensed indication] or doxycycline [unlicensed indication] for 7 days.

Question 4

When would the treatment of cutaneous anthrax be switched to amoxicillin?

Answer 4

If the infective strain is susceptible.

Question 5

When would treatment of cutaneous anthrax be extended to 60 days?

Answer 5

If the exposure is due to aerosol.

Question 6

A combination of antibacterials for 14 days is recommended for cutaneous anthrax with systemic features, extensive oedema, or lesions where?

Answer 6

A combination of antibacterials for 14 days is recommended for cutaneous anthrax with systemic features, extensive oedema, or lesions of the head or neck.

Question 7

What agents are used for post-exposure prophylaxis of anthrax?

Answer 7

Ciprofloxacin or doxycycline may be given for post-exposure prophylaxis. If exposure is confirmed, antibacterial prophylaxis should continue for 60 days. Antibacterial prophylaxis may be switched to amoxicillin after 10–14 days if the strain of B. anthracis is susceptible. Vaccination against anthrax may allow the duration of antibacterial prophylaxis to be shortened.

Question 8

If exposure to anthrax is confirmed, antibacterial prophylaxis should continue for how many days?

Answer 8

Ciprofloxacin or doxycycline may be given for post-exposure prophylaxis. If exposure is confirmed, antibacterial prophylaxis should continue for 60 days. Antibacterial prophylaxis may be switched to amoxicillin after 10–14 days if the strain of B. anthracis is susceptible. Vaccination against anthrax may allow the duration of antibacterial prophylaxis to be shortened.