Sandbox JA: Difference between revisions
Jump to navigation
Jump to search
Joao Silva (talk | contribs) No edit summary |
Joao Silva (talk | contribs) No edit summary |
||
| Line 2: | Line 2: | ||
Well-timed and effective postexposure [[prophylaxis]] can potentially save thousands of lives. Postexposure [[prophylaxis]] of [[asymptomatic]] persons should ideally start as soon as possible after exposure because its effectiveness decreases with delay in implementation. | Well-timed and effective postexposure [[prophylaxis]] can potentially save thousands of lives. Postexposure [[prophylaxis]] of [[asymptomatic]] persons should ideally start as soon as possible after exposure because its effectiveness decreases with delay in implementation. | ||
After exposure to anthrax, it is recommended 60 days of [[antibiotic]] drug [[prophylaxis]] for immediate protection and a 3-dose series of Anthrax Vaccine Adsorbed (AVA) for long-term protection.<ref name="pmid20651644">{{cite journal| author=Wright JG, Quinn CP, Shadomy S, Messonnier N, Centers for Disease Control and Prevention (CDC)| title=Use of anthrax vaccine in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009. | journal=MMWR Recomm Rep | year= 2010 | volume= 59 | issue= RR-6 | pages= 1-30 | pmid=20651644 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20651644 }} </ref> To ensure adequate and continued protection, everyone exposed to aerosolized [[Bacillus anthracis]] [[spores]] should receive a full 60 days of postexposure prophylaxis antibiotic drugs, whether they are unvaccinated, partially vaccinated, or fully vaccinated.<ref name=CDC>{{cite web | title = Centers for Disease Control and Prevention Expert Panel Meetings on Prevention and Treatment of Anthrax in Adults | url = http://wwwnc.cdc.gov/eid/article/20/2/13-0687_article }}</ref> | After exposure to anthrax, it is recommended 60 days of [[antibiotic]] drug [[prophylaxis]] for immediate protection and a 3-dose series of Anthrax Vaccine Adsorbed (AVA) for long-term protection.<ref name="pmid20651644">{{cite journal| author=Wright JG, Quinn CP, Shadomy S, Messonnier N, Centers for Disease Control and Prevention (CDC)| title=Use of anthrax vaccine in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009. | journal=MMWR Recomm Rep | year= 2010 | volume= 59 | issue= RR-6 | pages= 1-30 | pmid=20651644 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20651644 }} </ref> To ensure adequate and continued protection, everyone exposed to aerosolized [[Bacillus anthracis]] [[spores]] should receive a full 60 days of postexposure prophylaxis antibiotic drugs, whether they are unvaccinated, partially [[vaccinated]], or fully vaccinated.<ref name=CDC>{{cite web | title = Centers for Disease Control and Prevention Expert Panel Meetings on Prevention and Treatment of Anthrax in Adults | url = http://wwwnc.cdc.gov/eid/article/20/2/13-0687_article }}</ref> | ||
===Antibiotic Drugs=== | ===Antibiotic Drugs=== | ||
[[Ciprofloxacin]], [[levofloxacin]], and [[doxycycline]] are [[FDA]]-approved for the antibiotic drug portion of postexposure prophylaxis for inhalation anthrax in adults ≥18 years of age. | [[Ciprofloxacin]], [[levofloxacin]], and [[doxycycline]] are [[FDA]]-approved for the [[antibiotic]] drug portion of postexposure [[prophylaxis]] for inhalation anthrax in adults ≥18 years of age. | ||
No safety data are available for [[levofloxacin]] use beyond 30 days; thus, oral [[ciprofloxacin]] and [[doxycycline]] are recommended as first-line antibiotic drugs for postexposure prophylaxis | No safety data are available for [[levofloxacin]] use beyond 30 days; thus, oral [[ciprofloxacin]] and [[doxycycline]] are recommended as first-line [[antibiotic]] drugs for postexposure [[prophylaxis]]. Alternative [[antibiotic]] drugs that might be used for postexposure [[prophylaxis]], if first-line agents are not tolerated or are unavailable, include: | ||
* [[Levofloxacin]] and [[moxifloxacin]] | |||
* [[Amoxicillin]] and [[penicillin V Potassium]] if the isolate is [[penicillin]] susceptible | |||
* [[Clindamycin]]. | |||
===Vaccine=== | ===Vaccine=== | ||
There is evidence of [[seroconversion]] after 3 doses of AVA. The [[vaccine]] should be administered [[subcutaneous|subcutaneously]] at [[diagnosis]] and 2 and 4 weeks later.<ref name="pmid20651644">{{cite journal| author=Wright JG, Quinn CP, Shadomy S, Messonnier N, Centers for Disease Control and Prevention (CDC)| title=Use of anthrax vaccine in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009. | journal=MMWR Recomm Rep | year= 2010 | volume= 59 | issue= RR-6 | pages= 1-30 | pmid=20651644 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20651644 }} </ref> AVA is not FDA-approved for postexposure [[prophylaxis]] and could be made available under an Investigational New Drug protocol or an Emergency Use Authorization in a declared emergency. | |||
Revision as of 18:53, 17 July 2014
Primary Prevention
Well-timed and effective postexposure prophylaxis can potentially save thousands of lives. Postexposure prophylaxis of asymptomatic persons should ideally start as soon as possible after exposure because its effectiveness decreases with delay in implementation.
After exposure to anthrax, it is recommended 60 days of antibiotic drug prophylaxis for immediate protection and a 3-dose series of Anthrax Vaccine Adsorbed (AVA) for long-term protection.[1] To ensure adequate and continued protection, everyone exposed to aerosolized Bacillus anthracis spores should receive a full 60 days of postexposure prophylaxis antibiotic drugs, whether they are unvaccinated, partially vaccinated, or fully vaccinated.[2]
Antibiotic Drugs
Ciprofloxacin, levofloxacin, and doxycycline are FDA-approved for the antibiotic drug portion of postexposure prophylaxis for inhalation anthrax in adults ≥18 years of age.
No safety data are available for levofloxacin use beyond 30 days; thus, oral ciprofloxacin and doxycycline are recommended as first-line antibiotic drugs for postexposure prophylaxis. Alternative antibiotic drugs that might be used for postexposure prophylaxis, if first-line agents are not tolerated or are unavailable, include:
- Levofloxacin and moxifloxacin
- Amoxicillin and penicillin V Potassium if the isolate is penicillin susceptible
- Clindamycin.
Vaccine
There is evidence of seroconversion after 3 doses of AVA. The vaccine should be administered subcutaneously at diagnosis and 2 and 4 weeks later.[1] AVA is not FDA-approved for postexposure prophylaxis and could be made available under an Investigational New Drug protocol or an Emergency Use Authorization in a declared emergency.
- ↑ 1.0 1.1 Wright JG, Quinn CP, Shadomy S, Messonnier N, Centers for Disease Control and Prevention (CDC) (2010). "Use of anthrax vaccine in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009". MMWR Recomm Rep. 59 (RR-6): 1–30. PMID 20651644.
- ↑ "Centers for Disease Control and Prevention Expert Panel Meetings on Prevention and Treatment of Anthrax in Adults".