Centers for Disease Control and Prevention Expert Panel Meetings on Prevention and Treatment of Anthrax in Adults

Katherine A Hendricks,Tracee A Treadwell,Mary E Wright,Jon-Erik C Holty,Theresa L Smith,Sean V Shadomy,Nicki Pesik,Nancy E Messonnier,Meredith G Morrow,John S Bradley,William A Bower,Andy T Pavia,Ethan Rubinstein

doi:10.3201/eid2002.130687

Abstract

The Centers for Disease Control and Prevention convened panels of anthrax experts to review and update guidelines for anthrax postexposure prophylaxis and treatment. The panels included civilian and military anthrax experts and clinicians with experience treating anthrax patients. Specialties represented included internal medicine, pediatrics, obstetrics, infectious disease, emergency medicine, critical care, pulmonology, hematology, and nephrology. Panelists discussed recent patients with systemic anthrax; reviews of published, unpublished, and proprietary data regarding antimicrobial drugs and anthrax antitoxins; and critical care measures of potential benefit to patients with anthrax. This article updates antimicrobial postexposure prophylaxis and antimicrobial and antitoxin treatment options and describes potentially beneficial critical care measures for persons with anthrax, including clinical procedures for infected nonpregnant adults. Changes from previous guidelines include an expanded discussion of critical care and clinical procedures and additional antimicrobial choices, including preferred antimicrobial drug treatment for possible anthrax meningitis.

Highlights

Anemia can suddenly develop; thrombocytopenia onset often associated with hemolytic anemia; leukocytosis usually not seen until late in disease
Decreased sodium level; HCO3 level can be at reference level even with sepsis; increased blood urea nitrogen level
Standard blood work and diagnostic tests are recommended to evaluate acute infectious illnesses, anthrax is associated with unique findings

Summary

Introduction

Diagnosis, monitoring and assessment, therapy, prophylaxis, and mortality rates of patients with anthrax Standard blood work and diagnostic tests are recommended to evaluate acute infectious illnesses, anthrax is associated with unique findings.

Results

Conclusion