Sandbox anthrax01: Difference between revisions

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Latest revision as of 18:40, 17 July 2014

▸ Click on the following categories to expand treatment regimens.^[1]^[2]^[3]

Cutaneous Anthrax Without Systemic Involvement

▸ Adult Patients

▸ Pediatric Patients

▸ Pregnant Patients

Systemic Anthrax with Possible/Confirmed Meningitis

▸ Adult Patients

▸ Pediatric Patients

▸ Pregnant Patients

Systemic Anthrax Without Meningitis

▸ Adult Patients

▸ Pediatric Patients

▸ Pregnant Patients

Cutaneous Anthrax, Adult Patients
Preferred Regimen
▸ Ciprofloxacin 500 mg PO q12h OR ▸ Levofloxacin 750 mg PO q24h OR ▸ Moxifloxacin 400 mg PO q24h OR ▸ Doxycycline 100 mg PO q12h
Alternative Regimen
▸ Clindamycin 600 mg PO q8h OR ▸ Penicillin VK 500 mg PO q6h OR ▸ Amoxicillin 1 g PO q8h

Cutaneous Anthrax, Pediatric Patients
Preferred Regimen
▸ Ciprofloxacin 30 mg/kg/day PO q12h, max: 500 mg/dose OR ▸ Levofloxacin 16 mg/kg/day PO q12h, max: 250 mg/dose (<50 kg) OR ▸ Levofloxacin 500 mg PO q24h (≥50 kg) OR ▸ Doxycycline 4.4 mg/kg/day PO q12h, max: 100 mg/dose (<45 kg) OR ▸ Doxycycline 100 mg/dose PO q12h (≥45 kg)
Alternative Regimen
▸ Clindamycin 30 mg/kg/day PO q8h, max: 600 mg/dose OR ▸ Penicillin VK 50–75 mg/kg/day PO q6–8h OR ▸ Amoxicillin 75 mg/kg/day PO q8h, max: 1 g/dose

Cutaneous Anthrax, Pregnant Patients
Preferred Regimen
▸ Ciprofloxacin 500 mg PO q12h

Systemic Anthrax with Meningitis, Adult Patients
Preferred Regimen
▸ Ciprofloxacin 400 mg IV q8h OR ▸ Levofloxacin 750 mg IV q24h OR ▸ Moxifloxacin 400 mg IV q24h
PLUS
▸ Meropenem 2 g IV q8h OR ▸ Imipenem 1 g IV q6h OR ▸ Doripenem 500 mg IV q8h
PLUS
▸ Linezolid 600 mg IV q12h OR ▸ Clindamycin 900 mg IV q8h OR ▸ Rifampin 600 mg IV q12h OR ▸ Chloramphenicol 1 g IV q6–8h
Alternative Regimen
▸ Ciprofloxacin 400 mg IV q8h OR ▸ Levofloxacin 750 mg IV q24h OR ▸ Moxifloxacin 400 mg IV q24h
PLUS
▸ Penicillin G 4 MU IV q4h OR ▸ Ampicillin 3 g IV q6h
PLUS
▸ Linezolid 600 mg IV q12h OR ▸ Clindamycin 900 mg IV q8h OR ▸ Rifampin 600 mg IV q12h OR ▸ Chloramphenicol 1 g IV q6–8h

Systemic Anthrax with Meningitis, Pediatric Patients
Preferred Regimen
▸ Ciprofloxacin 30 mg/kg/day IV q8h, max: 400 mg/dose OR ▸ Levofloxacin 20 mg/kg/day IV q12h, max: 250 mg/dose (<50 kg) OR ▸ Levofloxacin 500 mg IV q24h (≥50 kg) OR ▸ Meropenem 60 mg/kg/day IV q12h, max: 2 g/dose OR ▸ Imipenem/Cilastatin 100 mg/kg/day IV q6h, max: 1 g/dose OR ▸ Vancomycin 60 mg/kg/day IV q8h
PLUS
▸ Clindamycin 30 mg/kg/day PO q8h, max: 600 mg/dose OR ▸ Linezolid 30 mg/kg/day IV q8h, max: 1 g/dose (<12 yr) OR ▸ Linezolid 30 mg/kg/day IV q12h, max: 600 mg/dose (≥12 yr) OR ▸ Doxycycline 4.4 mg/kg/day IV q12h, max: 100 mg/dose (<45 kg) OR ▸ Doxycycline 200 mg IV x1 then 100 mg IV q12h, max: 200 mg/dose (≥45 kg) OR ▸ Rifampin 20 mg/kg/day IV q12h, max: 300 mg/dose
Alternative Regimen
▸ Penicillin G 0.4 MU/kg/day IV q4h, max: 4 MU/dose OR ▸ Ampicillin 200 mg/kg/day IV q6h, max: 900 mg/dose
PLUS
▸ Clindamycin 30 mg/kg/day PO q8h, max: 600 mg/dose OR ▸ Linezolid 30 mg/kg/day IV q8h, max: 1 g/dose (<12 yr) OR ▸ Linezolid 30 mg/kg/day IV q12h, max: 600 mg/dose (≥12 yr) OR ▸ Doxycycline 4.4 mg/kg/day IV q12h, max: 100 mg/dose (<45 kg) OR ▸ Doxycycline 200 mg IV x1 then 100 mg IV q12h, max: 200 mg/dose (≥45 kg) OR ▸ Rifampin 20 mg/kg/day IV q12h, max: 300 mg/dose

Systemic Anthrax with Meningitis, Pregnant Patients
Preferred Regimen
▸ Ciprofloxacin 400 mg IV q8h
PLUS
▸ Clindamycin 900 mg IV q8h OR ▸ Rifampin 600 mg IV q12h
Alternative Regimen
▸ Levofloxacin 750 mg IV q24h OR ▸ Meropenem 2 g IV q8h OR ▸ Penicillin G 4 MU IV q4h OR ▸ Ampicillin 3 g IV q6h
PLUS
▸ Clindamycin 900 mg IV q8h OR ▸ Rifampin 600 mg IV q12h

Systemic Anthrax Without Meningitis, Adult Patients
Preferred Regimen
▸ Ciprofloxacin 400 mg q8h OR ▸ Levofloxacin 750 mg q24h OR ▸ Moxifloxacin 400 mg PO q24h OR ▸ Meropenem 2 g q8h OR ▸ Imipenem 1 g IV q6h OR ▸ Doripenem 500 mg q8h OR ▸ Vancomycin 60 mg/kg/day IV q8h, trough: 15–20 μg/mL
PLUS
▸ Clindamycin 900 mg q8h OR ▸ Linezolid 600 mg q12h OR ▸ Doxycycline 200 mg x1 then 100 mg IV q12h OR ▸ Rifampin 600 mg q12h
Alternative Regimen
▸ Penicillin G 4 MU IV q4h OR ▸ Ampicillin 3 g IV q6h
PLUS
▸ Clindamycin 900 mg q8h OR ▸ Linezolid 600 mg q12h OR ▸ Doxycycline 200 mg x1 then 100 mg IV q12h OR ▸ Rifampin 600 mg q12h

Systemic Anthrax Without Meningitis, Pediatric Patients
Preferred Regimen
▸ Ciprofloxacin 30 mg/kg/day IV q8h, max: 400 mg/dose OR ▸ Levofloxacin 16 mg/kg/day IV q12h, max: 250 mg/dose (<50 kg) OR ▸ Levofloxacin 500 mg IV q24h (≥50 kg) OR ▸ Moxifloxacin 12 mg/kg/day IV q12h, max: 200 mg/dose (3 mo–2 yr) OR ▸ Moxifloxacin 10 mg/kg/day IV q12h, max: 200 mg/dose (2 yr–5 yr) OR ▸ Moxifloxacin 8 mg/kg/day IV q12h, max: 200 mg/dose (6 yr–11 yr) OR ▸ Moxifloxacin 8 mg/kg/day IV q12h, max: 200 mg/dose (12 yr–17 yr, <45 kg) OR ▸ Moxifloxacin 400 mg IV q24h (12 yr–17 yr, ≥45 kg)
PLUS
▸ Meropenem 120 mg/kg/day IV q8h, max: 2 g/dose OR ▸ Imipenem/Cilastatin 100 mg/kg/day IV q6h, max: 1 g/dose OR ▸ Doripenem 120 mg/kg/day IV q8h, max: 1 g/dose OR ▸ Vancomycin 60 mg/kg/day IV q8h
PLUS
▸ Linezolid 30 mg/kg/day IV q8h, max: 600 mg/dose (<12 yr) OR ▸ Linezolid 30 mg/kg/day IV q12h, max: 600 mg/dose (≥12 yr) OR ▸ Clindamycin 40 mg/kg/day IV q8h, max: 900 mg/dose OR ▸ Rifampin 20 mg/kg/day IV q12h, max: 300 mg/dose OR ▸ Chloramphenicol 100 mg/kg/day IV q6h
Alternative Regimen
▸ Ciprofloxacin 30 mg/kg/day IV q8h, max: 400 mg/dose OR ▸ Levofloxacin 16 mg/kg/day IV q12h, max: 250 mg/dose (<50 kg) OR ▸ Levofloxacin 500 mg IV q24h (≥50 kg) OR ▸ Moxifloxacin 12 mg/kg/day IV q12h, max: 200 mg/dose (3 mo–2 yr) OR ▸ Moxifloxacin 10 mg/kg/day IV q12h, max: 200 mg/dose (2 yr–5 yr) OR ▸ Moxifloxacin 8 mg/kg/day IV q12h, max: 200 mg/dose (6 yr–11 yr) OR ▸ Moxifloxacin 8 mg/kg/day IV q12h, max: 200 mg/dose (12 yr–17 yr, <45 kg) OR ▸ Moxifloxacin 400 mg IV q24h (12 yr–17 yr, ≥45 kg)
PLUS
▸ Penicillin G 0.4 MU/kg/day IV q4h, max: 4 MU/dose OR ▸ Ampicillin 400 mg/kg/day IV q6h, max: 3 g/dose
PLUS
▸ Linezolid 30 mg/kg/day IV q8h, max: 600 mg/dose (<12 yr) OR ▸ Linezolid 30 mg/kg/day IV q12h, max: 600 mg/dose (≥12 yr) OR ▸ Clindamycin 40 mg/kg/day IV q8h, max: 900 mg/dose OR ▸ Rifampin 20 mg/kg/day IV q12h, max: 300 mg/dose OR ▸ Chloramphenicol 100 mg/kg/day IV q6h

Systemic Anthrax Without Meningitis, Pregnant Patients
Preferred Regimen
▸ Ciprofloxacin 400 mg IV q8h
PLUS
▸ Clindamycin 900 mg IV q8h OR ▸ Rifampin 600 mg IV q12h
Alternative Regimen
▸ Levofloxacin 750 mg IV q24h OR ▸ Meropenem 2 g IV q8h OR ▸ Penicillin G 4 MU IV q4h OR ▸ Ampicillin 3 g IV q6h
PLUS
▸ Clindamycin 900 mg IV q8h OR ▸ Rifampin 600 mg IV q12h

References

↑ Hendricks, Katherine A. (2014-02). "Centers for disease control and prevention expert panel meetings on prevention and treatment of anthrax in adults". Emerging Infectious Diseases. 20 (2). doi:10.3201/eid2002.130687. ISSN 1080-6059. PMC 3901462. PMID 24447897. Unknown parameter |coauthors= ignored (help); Check date values in: |date= (help)CS1 maint: PMC format (link)
↑ Bradley, John S. (2014-04-28). "Pediatric Anthrax Clinical Management". Pediatrics. doi:10.1542/peds.2014-0563. ISSN 1098-4275. PMID 24777226. Unknown parameter |coauthors= ignored (help)
↑ Meaney-Delman, Dana (2014-02). "Special considerations for prophylaxis for and treatment of anthrax in pregnant and postpartum women". Emerging Infectious Diseases. 20 (2). doi:10.3201/eid2002.130611. ISSN 1080-6059. PMC 3901460. PMID 24457117. Unknown parameter |coauthors= ignored (help); Check date values in: |date= (help)CS1 maint: PMC format (link)

[1] Hendricks, Katherine A. (2014-02). "Centers for disease control and prevention expert panel meetings on prevention and treatment of anthrax in adults". Emerging Infectious Diseases. 20 (2). doi:10.3201/eid2002.130687. ISSN 1080-6059. PMC 3901462. PMID 24447897. Unknown parameter |coauthors= ignored (help); Check date values in: |date= (help)CS1 maint: PMC format (link)

[2] Bradley, John S. (2014-04-28). "Pediatric Anthrax Clinical Management". Pediatrics. doi:10.1542/peds.2014-0563. ISSN 1098-4275. PMID 24777226. Unknown parameter |coauthors= ignored (help)

[3] Meaney-Delman, Dana (2014-02). "Special considerations for prophylaxis for and treatment of anthrax in pregnant and postpartum women". Emerging Infectious Diseases. 20 (2). doi:10.3201/eid2002.130611. ISSN 1080-6059. PMC 3901460. PMID 24457117. Unknown parameter |coauthors= ignored (help); Check date values in: |date= (help)CS1 maint: PMC format (link)

[1]

[2]

[3]

@@ Line 1: / Line 1: @@
-<!--
+<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL><ref>{{Cite journal | doi = 10.3201/eid2002.130687 | issn = 1080-6059 | volume = 20 | issue = 2 | last = Hendricks | first = Katherine A. | coauthors = Mary E. Wright, Sean V. Shadomy, John S. Bradley, Meredith G. Morrow, Andy T. Pavia, Ethan Rubinstein, Jon-Erik C. Holty, Nancy E. Messonnier, Theresa L. Smith, Nicki Pesik, Tracee A. Treadwell, William A. Bower, Workgroup on Anthrax Clinical Guidelines | title = Centers for disease control and prevention expert panel meetings on prevention and treatment of anthrax in adults | journal = Emerging Infectious Diseases | date = 2014-02 | pmid = 24447897 | pmc = PMC3901462 }}</ref><ref>{{Cite journal | doi = 10.1542/peds.2014-0563 | issn = 1098-4275 | last = Bradley | first = John S. | coauthors = Georgina Peacock, Steven E. Krug, William A. Bower, Amanda C. Cohn, Dana Meaney-Delman, Andrew T. Pavia, AAP COMMITTEE ON INFECTIOUS DISEASES and DISASTER PREPAREDNESS ADVISORY COUNCIL | title = Pediatric Anthrax Clinical Management | journal = Pediatrics | date = 2014-04-28 | pmid = 24777226 }}</ref><ref>{{Cite journal | doi = 10.3201/eid2002.130611 | issn = 1080-6059 | volume = 20 | issue = 2 | last = Meaney-Delman | first = Dana | coauthors = Marianne E. Zotti, Andreea A. Creanga, Lara K. Misegades, Etobssie Wako, Tracee A. Treadwell, Nancy E. Messonnier, Denise J. Jamieson, Workgroup on Anthrax in Pregnant and Postpartum Women | title = Special considerations for prophylaxis for and treatment of anthrax in pregnant and postpartum women | journal = Emerging Infectious Diseases | date = 2014-02 | pmid = 24457117 | pmc = PMC3901460 }}</ref>
-==Empiric Therapy <SMALL><SMALL><SMALL><SMALL><SMALL>Adapted from ''Lancet. 2012;380(9854):1693-702.''<ref name="van de Beek-2012">{{Cite journal  | last1 = van de Beek | first1 = D. | last2 = Brouwer | first2 = MC. | last3 = Thwaites | first3 = GE. | last4 = Tunkel | first4 = AR. | title = Advances in treatment of bacterial meningitis. | journal = Lancet | volume = 380 | issue = 9854 | pages = 1693-702 | month = Nov | year = 2012 | doi = 10.1016/S0140-6736(12)61186-6 | PMID = 23141618 }}</ref> and ''Clin Infect Dis. 2004;39(9):1267-84.''<ref name="pmid15494903">Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM et al. (2004) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=15494903 Practice guidelines for the management of bacterial meningitis.] ''Clin Infect Dis'' 39 (9):1267-84. [http://dx.doi.org/10.1086/425368 DOI:10.1086/425368] PMID: [http://pubmed.gov/1549490315494903]</ref></SMALL></SMALL></SMALL></SMALL></SMALL>==
--->
-<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL>
 {|
@@ Line 95: / Line 89: @@
 | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Ciprofloxacin]]  500 mg PO q12h'''''<BR> OR <BR> ▸ '''''[[Levofloxacin]]  750 mg PO q24h'''''<BR> OR <BR> ▸ '''''[[Moxifloxacin]]  400 mg PO q24h'''''<BR> OR <BR> ▸ '''''[[Doxycycline]]  100 mg PO q12h'''''
 |-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Alternative Regimen (for Penicillin-Susceptible Strains)
+| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Alternative Regimen
 |-
 | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Clindamycin]] 600 mg PO q8h'''''<BR> OR <BR> ▸ '''''[[Penicillin VK]] 500 mg PO q6h'''''<BR> OR <BR> ▸ '''''[[Amoxicillin]] 1 g PO q8h'''''
@@ Line 110: / Line 104: @@
 | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Ciprofloxacin]] 30 mg/kg/day PO q12h, max: 500 mg/dose'''''<BR> OR <BR> ▸ '''''[[Levofloxacin]]  16 mg/kg/day PO q12h, max: 250 mg/dose (<50 kg)'''''<BR> OR <BR> ▸ '''''[[Levofloxacin]]  500 mg PO q24h (≥50 kg)'''''<BR> OR <BR> ▸ '''''[[Doxycycline]]  4.4 mg/kg/day PO q12h, max: 100 mg/dose (<45 kg)'''''<BR> OR <BR> ▸ '''''[[Doxycycline]]  100 mg/dose PO q12h (≥45 kg)'''''
 |-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Alternative Regimen (for Penicillin-Susceptible Strains)
+| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Alternative Regimen
 |-
 | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Clindamycin]] 30 mg/kg/day PO q8h, max: 600 mg/dose'''''<BR> OR <BR> ▸ '''''[[Penicillin VK]] 50–75 mg/kg/day PO q6–8h'''''<BR> OR <BR> ▸ '''''[[Amoxicillin]] 75 mg/kg/day PO q8h, max: 1 g/dose'''''
@@ Line 144: / Line 138: @@
 | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Linezolid]]  600 mg IV q12h'''''<BR> OR <BR> ▸ '''''[[Clindamycin]]  900 mg IV q8h'''''<BR> OR <BR> ▸ '''''[[Rifampin]]  600 mg IV q12h'''''<BR> OR <BR> ▸ '''''[[Chloramphenicol]] 1 g IV q6–8h'''''
 |-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Alternative Regimen (for Penicillin-Susceptible Strains)
+| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Alternative Regimen
 |-
 | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Ciprofloxacin]]  400 mg IV q8h'''''<BR> OR <BR> ▸ '''''[[Levofloxacin]]  750 mg IV q24h'''''<BR> OR <BR> ▸ '''''[[Moxifloxacin]]  400 mg IV q24h'''''
@@ Line 217: / Line 211: @@
 | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Clindamycin]]  900 mg q8h'''''<BR> OR <BR> ▸ '''''[[Linezolid]]  600 mg q12h'''''<BR> OR <BR> ▸ '''''[[Doxycycline]]  200 mg x1 then 100 mg IV q12h'''''<BR> OR <BR> ▸ '''''[[Rifampin]]  600 mg q12h'''''
 |-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Alternative Regimen (for Penicillin-Susceptible Strains)
+| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Alternative Regimen
 |-
 | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Penicillin G]] 4 MU IV q4h'''''<BR> OR <BR> ▸ '''''[[Ampicillin]] 3 g IV q6h'''''

Sandbox anthrax01: Difference between revisions

Latest revision as of 18:40, 17 July 2014

References

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