Anthrax treatment

Treatment (See Inhalational Anthrax Treatment Protocol at http //www.cdc.gov/ mmwr/preview/mmwrhtinl/m in5042al.htm for specific therapy)... 

Sources (1) Stubbs MT. Anthrax X-rayed new opportunities for biodefence, Trends in Pharmacological Sciences 23 539-541 (2002). (2) Center for Disease Control and Prevention. Anthrax Treatment, http //www.bt.cdc.gov/agent/anthrax/faq/treatment.asp [accessed September 27,2007]. 

Decontamination Soap and water, or diluted sodium hypochlorite solution (0.5 percent). Drainage and secretion precautions are necessary. After invasive procedures or autopsy, decontaminate instruments and surfaces with 0.5 percent sodium hypochlorite or with a sporici Anthrax, after symptoms have became apparent, can be very deadly. Although the death rate for dermal anthrax is roughly about five to 20 percent, the fatality rate for inhalation anthrax after symptoms progress is almost always fatal, regardless of treatment. 

Currently, the FDA approved treatment for anthrax is ciprofloxacin, doxycycline, and penicillin. 

Chlorine dioxide is a yellow to reddish-yellow gas that can decompose rapidly in air. Because it is a hazardous gas, chlorine dioxide is always made at the place where it is used. Chlorine dioxide is used as a bleach at pulp mills, which make paper and paper products, and in public water treatment facilities, to make water safe to drink. In 2001, chlorine dioxide was used to decontaminate a number of public buildings following the release of anthrax spores in the United States. Chlorine dioxide is soluble in water and will rapidly react with other compounds. When it reacts in water, chlorine dioxide will form chlorite ion, which is also a very reactive compound. 

Levofloxacin (1), the levo-isomer or the (5)-enantiomer of ofloxacin, received FDA approval in 1996 (Fish, 2003 Hurst et al., 2002 Mascaretti, 2003 Norrby, 1999 North et al., 1998). The initial approval covered community-acquired pneumonia, acute bacterial exacerbation of chronic bronchitis, acute maxillary sinusitis, uncomplicated skin and skin structure infections, acute pyelonephritis, and complicated urinary tract infections (North et al., 1998). Four years later, the levofloxacin indication list grew to include community-acquired pneumonia caused by penicillin-resistant Streptococcus pneumoniae. In addition, in 2002, nosocomial (hospital-acquired) pneumonia caused by methicillin-susceptible Staphylococcus aureus, Pseudomonas aeruginosa, Serratia marcescens, Haemophilus influenzae, Kliebsella pneumoniae, and Escherichia coli was added (Hurst et al., 2002). Finally in 2004, LVX was approved as a post-exposure treatment for individuals exposed to Bacillus anthracis, the microbe that causes anthrax, via inhalation (FDA, 2004). 

Two tetracyclines have sufficiently distinctive features to warrant separate mention. Doxycycline, with its longer half-hfe and lack of nephrotoxicity, is a popular choice for patients with preexisting renal disease or those who are at risk for developing renal insufficiency. The lack of nephrotoxicity is related mainly to biliary excretion, which is the primary route of doxycycline elimination. Doxycycline is the preferred parenteral tetracycline Doxycycline is a potential first-hne agent in the prophylaxis of anthrax after exposure. Doxycycline is the treatment of choice for the primary stage of Lyme disease in adults and children older than 8 years. 

Treatment of inflammatory acne, anthrax, gonorrhea, skin infections, urinary tract infection (UTI) IM 250 mg/day or 300 mg/day divided q8-12h Dosage in renal impairment ... 

Pre-1900 Treatment of rabies, anthrax, and smallpox Principles of infection control and pain relief Management of heart failure... 

Cethromycin (ABT-773) 39 (Advanced Life Sciences) had an NDA filed in October 2008 for the treatment of CAP.67 Advanced Life Sciences is also evaluating cethromycin 39 against other respiratory tract infections and in pre-clinical studies as a prophylactic treatment of anthrax post-exposure. Cethromycin 3968 70 is a semi-synthetic ketolide derivative of erythromycin 4071 originally synthesised by Abbott Laboratories,72 which like erythromycin 40, inhibits bacterial protein synthesis through binding to the peptidyl-transferase site of the bacterial 50S ribosomal subunit. Important macrolide antibiotics in clinical use today include erythromycin 40 itself, clarithromycin, azithromycin and, most recently, telithromycin (launched in 2001). 

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