The prophylaxis and treatment of anthrax.

Bacillus anthracis infection can occur in three forms: cutaneous, gastrointestinal and inhalation depending on the mode of infection. Anthrax is a zoonotic disease but the inhalation form can also be used as a biological warfare agent. The recent mail spread outbreak of bioterrorism-related infections in the USA prompted the introduction of specific guidelines by the USA Centers for Disease Control and Prevention. Postexposure prophylaxis is indicated to prevent inhalational anthrax, and therapy with ciprofloxacin or doxycycline is recommended for adults and children for 60 days. The same agents are also advocated for the treatment of inhalation anthrax. However, therapy with two or more antimicrobial agents that are predicted to be effective are recommended. Other agents with in vitro activity are also suggested for be use in conjunction with ciprofloxacin or doxycycline include rifampciin, vancomycin, imipenem, chloramphenicol, penicillin and ampicillin, clindamycin, and clarithromycin.