POLICY FOR ANTIBIOTIC USE IN ANTHRAX

File: 120396_sep96_decls24_0001.txt
Page: 0001
Total Pages: 1

Subject: POLICY FOR ANTIBIOTIC USE IN ANTHRAX                            

Unit: OTSG        

Parent Organization: HSC         

Box ID: BX003203

Folder Title: POLICY FOR ANTIBIOTIC USE IN ANTHRAX                                                            

Document Number:          1

Folder SEQ  #:        181







                              DEPARTMENT OF THE ARMY
                            OFFICE OF THE SURGEON GENERAL
                                    5109 LEESBURG PIKE
                ftgply Iro       FALLS CHUPTCH. VA 22041-32@58
                ATTGNTION OF
           SGPS-PSP


           MEMORANDUM FOR COL ROBERT P. BELIHAR, COMMAND SURGEON, USCENTCOMT
                             KACDILL AIR FORCE BASE, FL 33608-7001

           SUBJECT: Policy for Antibiotic Use in Anthrax


           1. Purpose: To present the recommended policy for antibiotic
           use in anthrax.

           2. Discussion: A biowarfare attack with anthrax spores
           delivered by aerosol would cause inhalation anthrax. Inhalation
           anthrax begins with non-specific symptoms followed in 2-3 days by
           the sudden onset of severe respiratory distress and toxemia
           leading rapidly to death. Treatment with penicillin, initiated
           at the toxemic stage of the disease, has been unsuccessful.
           Limited experiments in aerosol-infected monkeys showed that
           post-exposure prophylaxis with a short course of antibiotics was
           ineffective while combining a short course of antibiotics with
           vaccination on days 1 and 10 post-exposure was protective. The
           vast majority of anthrax strains are sensitive in vitro to
           penicillin, however, resistant strains exist. All strains tested
           to date have been sensitive to tetracycline, erythromycin,
           chloramphenicoll gentamicin, and ciprofloxacin.

           3. Recommendations:

               a. Prophylaxis. If a biowarfare attack is imminent, begin
           ciprofloxacin (500 mg p.o. bid) or doxycycline (100 mg p.o. bid).
           If unvaccinated, a single 0.5 ml dose of vaccine should be given
           subcutaneously. If the attack is confirmed, antibiotics should
           be continued for 4 weeks and 0.5 ml doses of vaccine given at 2
 Those previously vaccinated
           should receive a single 0.5 ml booster. If vaccine is not avail-
           able, antibiotics should be continued until the patient can be
           closely observed upon discontinuation of therapy. If signs of
           anthrax occur after cessation they should be treated as below.

               b. Suspected Inhalation Anthrax. Institute treatment at the
           earliest signs of disease with oral ciprofloxacin (1000 mg
           initially followed by 750 mg bid) or              doxycycline (200
           mg initially followed by 100 mg q 12 hours).




                                           FREDERICK J. ERDT14ANN
                                            Colonel# MC
                                            Chieft Preventive and Military
                                              Medical Consultants Division

Document 1 f:/Week-36/BX003203/POLICY FOR ANTIBIOTIC USE IN ANTHRAX/policy for antibiotic use in anthrax:11089615090925
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-36
Box ID = BX003203
Unit = OTSG
Parent Organization = HSC
Folder Title = POLICY FOR ANTIBIOTIC USE IN ANTHRAX
Folder Seq # = 181
Subject = POLICY FOR ANTIBIOTIC USE IN ANTHRAX
Document Seq # = 1
Document Date =
Scan Date =
Queued for Declassification = 01-JAN-1980
Short Term Referral = 01-JAN-1980
Long Term Referral = 01-JAN-1980
Permanent Referral = 01-JAN-1980
Non-Health Related Document = 01-JAN-1980
Declassified = 08-NOV-1996