The Center for Disease Control released guidelines on Jan. 15 relating to anthrax treatment, exposure prevention and precautions specific to pregnant and postpartum women.
The guidelines were created by the CDC's Expert Panel Meetings on Prevention and Treatment of Anthrax in Adults, which was staffed by anthrax and critical care experts recommended by the CDC, the Food and Drug Administration, National Institutes of Health and university medical centers. The panel determined that doctors should prioritize obtaining blood samples and other cultures from patients suspected of anthrax exposure.
The panel said doctors should monitor blood flow through the patient's organs and measure oxygen levels in the blood. Patients who inhale anthrax may require ventilation to assists with difficulty breathing and swelling in the airway.
The panel said that anyone exposed to Bacillus anthracis spores through inhalation should be treated with a 30-day postexposure prophylaxis regimen of antimicrobial drugs. First-line treatment includes oral doxycycline and ciprofloxacin.
Antitoxin drugs such as raxibacumab and anthrax immune globulin appear to be effective, according to the panel. Antimicrobial drugs are effective by themselves if they are administered early enough.
For anthrax meningitis, the panel recommended ciprofloxacin, meropenem and linezolid be used for two weeks until symptoms have stabilized.
In the case of pregnancy, the panel recommended doxycycline not be used, but approved the use of ciprofloxacin. A regimen of corticosteroids was also recommended to reduce the risk of preterm labor and improve fetal outcome.