Anthrax Health Article

Treatment

Most people with anthrax are treated with antibiotics. Several antibiotics are effective, including penicillin, doxycycline, and ciprofloxacin.

When treating inhalational anthrax, a combination of antibiotics should be used. Doctors often start treatment ciprofloxacin plus another drug, given through a vein (intravenously).

Cutaneous anthrax is treated with antibiotics taken by mouth, usually for 7 to 10 days.

The length of treatment for inhalation anthrax is currently about 60 days, since it may take anthrax spores that long to grow.

In the event of a bioterrorist attack, the National Pharmaceutical Stockpile is available to help provide antibiotics should a shortage occur.

Expectations (prognosis)

When treated with antibiotics, cutaneous anthrax is likely to get better. However, up to 20% of people who do not get treatment may die due to anthrax-related blood infections.

People with second-stage inhalation anthrax have a poor outlook, even with antibiotic therapy. Up to 90% of cases in the second stage are fatal.

Gastrointestinal anthrax infection can spread to the bloodstream, and may result in death.

Complications

Cutaneous anthrax:

• Spread of infection into the bloodstream

Inhalational anthrax:

• Hemorrhagic meningitis
• Swelling of lymph nodes in the chest (mediastinal adenopathy)
• Fluid buildup in the chest (pleural effusion)
• Shock
• Death

Gastrointestinal anthrax

• Severe bleeding (hemorrhage)
• Shock
• Death

Calling your health care provider

Call your health care provider if you have been exposed to anthrax, or if you develop symptoms of any type of anthrax.

Prevention

There are two main ways to prevent anthrax.

For people who have been exposed to anthrax (but have no symptoms of the disease), doctors may prescribe preventive antibiotics, such as ciprofloxacin, penicillin, or doxycycline, depending on the strain of anthrax.

An anthrax vaccine is available to certain military personnel, but not to the general public. It is given in a series of six doses over 18 months. There is no known way to spread cutaneous anthrax from person to person. People who live with someone who has cutaneous anthrax do not need antibiotics unless they have also been exposed to the same source of anthrax.

References

Inglesby TV, O'Toole T, Henderson DA, et al. Anthrax as a Biological Weapon, 2002. JAMA.160;2002;287:2236-2252.

Lucey DR, Anthrax. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 317.