Purpose-The Infectious Diseases Society of America and US CDC recommend 60 days of ciprofloxacin, doxycycline or amoxicillin for anthrax prophylaxis. It is not possible to determine severe adverse drug event (ADE) risks from the few people thus far exposed to anthrax Corresponding author: Sharon B. Meropol, M.D., M.S.C.E., University of Pennsylvania School of Medicine, Center for Clinical Epidemiology and Biostatistics, Room 108, Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, Phone: 215-499-2421; FAX: 215-573-6228; smeropol@mail.med.upenn.edu.
Potential conflicts of interest:Dr. Meropol has served as a consultant for Wyeth Pharmaceuticals and is supported, in part by an educational grant from Amgen. Dr. Hennessy has served as a consultant for Sanofi-Aventis and performed legal consulting regarding an antibiotic not related to this study. Dr. Lautenbach has received research grants from Merck & Co., Inc. and has served as a consultant for Ortho McNeil and Bristol-Myers-Squibb. Dr. Platt has had research support and/or consulted for the following: America's Health Insurance Plans, Agency for Healthcare Research, and Quality, Centers for Disease Control and Prevention, Crohn's and Colitis Foundation of America, Food and Drug Administration, GlaxoSmithKline, Massachusetts Department of Public Health, National Cancer Institute, National Heart, Lung and Blood Institute, National Institute of Allergy and Infectious Disease, National Institute of Diabetes, Digestive and Kidney Disease, National Institute of General Medical Sciences, National Committee for Quality Assurance, Parke Davis, Pfizer, Robert Wood Johnson Foundation, Sanofi-Aventis, Sanofi-Pasteur, SmithKlineBeecham, Tap Pharmaceuticals, and Wyeth. The remaining authors have nothing to declare. Conclusions-Long-term amoxicillin, ciprofloxacin and doxycycline appears safe, supporting use of these medications if needed for large-scale post-exposure anthrax prophylaxis.
NIH Public Access
KeywordsAnti-infective agents; Anthrax prevention and control; Health services research; Databases; Bioterrorism Recent concerns regarding the potential for intentional release of bioterrorism agents, particularly regarding the threat of anthrax exposure, have drawn attention to the possible need for large-scale post-exposure antibiotic prophylaxis. Treatment choices should reflect a balance between the expected benefits and risks of alternative treatment strategies. As data are limited regarding treatments' relative effectiveness in preventing infection, the anticipated risks related to each agent's use should play an important role in developing treatment recommendations.For adult and pediatric post-exposure anthrax prophylaxis, the Infectious Diseases Society of America and the U.S. Centers for Disease Control and Prevention (CDC) recommend a 60-day course of ciprofloxacin, doxycycline, or amoxicillin. 1-3 A recent study reported that amoxicillin was the third most common drug implicated in adverse drug events (ADEs) treated in U.S. emergency departments, a...