CDC guidelines on prophylactic treatment of anthrax exposure

doi:10.1136/bmjusa.01110003

BMJ, doi: 10.1136/bmjusa.01110003, (Published 4 September 2002)

Editorials

CDC guidelines on prophylactic treatment of anthrax exposure

This article originally appeared in BMJ USA

In interim recommendations published by the US Centers for Disease Control and Prevention (CDC) in the Morbidity and MortalityWeekly Report,¹ the CDC recommended either ciprofloxacin ordoxycycline as initial therapy for postexposure prophylaxis forprevention of infection with B anthracis. In a health advisoryissued on October 31, 2001, the CDC noted that ciprofloxacin iseffective against many common pathogens that are now resistantto tetracyclines such as doxycycline. "To preserve the effectivenessof ciprofloxacin against other infections," said the CDC, "useof doxycycline for prevention of B anthracis infection is reasonable."²

The CDC recommends ciprofloxacin as the antibiotic of choice for initial prophylactic therapy among asymptomatic pregnantwomen exposed to B anthracis. When the specific strain of B anthracishas been shown to be penicillin-sensitive, prophylactic therapywith amoxicillin may be considered.³

Readers should consult the CDC's website (www.bt.cdc.gov) for the most current and detailed information and guidelines aboutmanaging bioterrorism-related threats, exposures, andinfections.

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1.	US Centers for Disease Control and Prevention. Update: Investigation of anthrax associated with intentional exposure and interim public health guidelines, October 2001. MMWR 2001; 50: 889-893[Medline].
2.	US Centers for Disease Control and Prevention. Official CDC health advisory: Use of ciprofloxacin or doxycycline for postexposure prophylaxis for prevention of inhalational anthrax. www.bt.cdc.gov/DocumentsApp/Anthrax/10312001/han49.asp (accessed November 4, 2001)
3.	US Centers for Disease Control and Prevention. Updated recommendations for antimicrobial prophylaxis among asymptomatic pregnant women after exposure to Bacillus anthracis. MMWR 2001; 50: 960[Medline].