TRANSMITTAL OF POLICY MEMORANDA

File: 120396_sep96_decls86_0003.txt
Page: 0003
Total Pages: 6

Subject: TRANSMITTAL OF POLICY MEMORANDA                                 

Unit: OTSG        

Parent Organization: HSC         

Box ID: BX003203

Folder Title: TRANSMITAL OF POLICY MEMORANDA                                                                  

Document Number:          1

Folder SEQ  #:        179






                                DEPARTMENT OF THE ARMY
                              OFFICE OF THE SURGEON GENERAL
                                      5109 LEESBURG PIKE
                                   FALLS CHURCH. VA 22041-3258


                 REPLY TO
                 A@ENTION OF
            SGPS-PSP


            MEMORANDUM FOR COL ROBERT P. BELIHAR, COMMAND SURGEON, Ul            -Om,
                              MACDILL AIR FORCE BASE, FL 33608-7001

            SUBJECT: Policy for Antibiotic Use in Anthrax


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

            2. Discussion: A biowarfare attack with anthrax spores
            delivered by aerosol would cause inhalation anthrax. In'l            on
            anthrax begins with non-specific symptoms followed in 2-      '      ; by
            the sudden onset of severe respiratory distress and toxel
            leading rapidly to death. Treatment with penicillin, in              !d
            at the toxemic stage of the disease, has been unsuccessfi
            Limited experiments in aerosol-infected monkeys showed ti
            post-exposure prophylaxis with a short course of antibio             Pas
            ineffective while combining a short course of antibiotic:            I
            vaccination on days 1 and 10 post-exposure was protective            ie
            vast majority of anthrax strains are sensitive in vitro -
            penicillin, however, resistant strains exist. All strai,             ;ted
            to date have been sensitive to tetracycline, erythromycin
            chloramphenicol, gentamicin, and ciprofloxacin.

            3. Recommendations:

                a. Prophylaxis. If a biowarfare attack is imminent               n
            ciprqfloxacin (500 mg p.o. bid) or doxycycline (100 mg p             d).
            if unvaccinated, a single 0.5 ml dose of vaccine should I            'en
biotics              d
            be continued for 4 weeks and 0.5 ml doses of vaccine giv4            2
            and 4 weeks after the initial dose. Those previously vai             ed
            should receive a single 0.5 ml booster. If vaccine is n4             il-
            able, antibiotics should be continued until the patienti
            closely observed upon discontinuation of therapy. If si(
            anthrax occur after cessation, they should be treated as

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




                                              FREDERICK J. ERDTMANN
                                              Colonel, MC
                                               Chief, Preventive and Mi.
                                                 Medical Consultants Di@

Document 6 f:/Week-36/BX003203/TRANSMITAL OF POLICY MEMORANDA/transmittal of policy memoranda:11259610133626
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-36
Box ID = BX003203
Unit = OTSG
Parent Organization = HSC
Folder Title = TRANSMITAL OF POLICY MEMORANDA
Folder Seq # = 179
Subject = TRANSMITTAL OF POLICY MEMORANDA
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 = 25-NOV-1996