Should persons exposed to an unknown powder receive prophylactic therapy?
What is the recommended therapy? Most exposures to date have been hoaxes. The state health department or CDC will have the latest news regarding a significant exposure as well as information to help guide treatment. In most cases, anthrax is responsive to multiple antibiotics, including chloramphenicol, erythromycin, clindamycin, and rifampin, but not to cephalosporins or trimethoprim/sulfamethoxazole. Penicillin should not be used as the sole drug for prophylactic treatment, because isolates from recent cases have been found to contain beta-lactamase. Prophylactic ciprofloxacin therapy is recommended for two reasons. First, it is FDA approved for this purpose, and second, multidrug-resistant strains of anthrax can be prevented by administering a single drug nationwide. The recommended prophylactic dosage is 500 mg taken orally twice daily for 60 days. The adjusted dosage for children is 20 to 30 mg/kg/day in divided doses every 12 hours. Although ciprofloxacin is usually not recommend
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