Table 1

Treatment protocols for inhalation anthrax

Patient categoryIntravenous (IV) treatmentLong term treatment‡
Once patients have stabilised clinically, the IV treatment may be switched to oral and monotherapy may be used to complete the 60 day course. Other antibiotics that are active in vitro against the current strain are: ampicillin, penicillin, clindamycin, clarithromycin, imipenem/meropenem, vancomycin, rifampicin, and chloramphenicol.
*Pregnant women and immunocompromised patients should receive the same treatment; †consider steroids with severe oedema or meningitis; ‡one drug may be used when the patient has stabilised.
bd, twice daily.
Adult*Ciprofloxacin 400 mg IV bd or doxycycline 100 mg IV bd plus 1 or 2 other antibiotics†Switch to oral treatment when clinically appropriate. Ciprofloxacin 500 mg bd or doxycycline 100 mg bd to complete 60 days
ChildrenCiprofloxacin 10–15 mg IV bd. Doxycycline >8 years >45 kg: 100 mg IV bd 8 years <45 kg or <8 years: 2.2 mg/kg bd +1 or 2 other antibiotics†Switch to oral antibiotic when clinically appropriate. Ciprofloxacin 10–15 mg/kg bd or doxycycline (same dose regimen) to complete 60 days