TITLE: BIOLOGIC WEAPONS
AUTHOR: THOMAS P. NOELLER, MD -- Department of Emergency Medicine
PUBLISHED: MAY 30, 2002
     
Table 1:
Most Likely Agents of Biologic Terrorism

Variola major (smallpox)

Bacillus anthracis (anthrax)

Yersinia Pestis (plague)

Clostridium botulinum toxin

Francisella tularensis (tularemia)

Filoviruses
      Ebola hemorrhagic fever
      Marburg hemorrhagic       fever

Arenaviruses
      Lassa (Lassa fever)
      Junin (Argentine       hemorrhagic fever)
Adapted from Reference 1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Table 2:
CDC Recommendations for Antimicrobial Therapy Against Anthrax
  Indication
Adults
Children
Postexposure
prophylaxis
Ciprofloxacin 500 mg by mouth twice a day
OR
Doxycycline 100 mg by mouth twice a day

Ciprofloxacin 10-15 mg/kg by mouth every 12 hours*

OR

Doxycycline:
            > 8 years and > 45 kg:
                           100 mg by mouth every 12 hours
            > 8 years and < 45 kg:
                           2.2 mg/kg by mouth every 12 hours
            < 8 years:
                           2.2mg/kg by mouth every 12 hours
Cutaneous anthrax

Ciprofloxacin 500 mg by mouth twice a day
OR
Doxycycline 100 mg by mouth twice a day

 

Ciprofloxin 10-15 mg/kg by mouth every 12 hours*

OR

Doxycycline:
         > 8 years and > 45 kg:
                   100 mg by mouth every 12 hours
         > 8 years and < 45 kg:
                    2.2 mg/kg by mouth every 12 hours
         < 8 years:
                    2.2 mg/kg by mouth every 12 hours
                    
          

Inhalation anthrax

Ciprofloxacin 400 mg
intravenously every 12 hours
OR
Doxycycline 100 mg intravenously every 12 hours
Plus (for either drug)
One or two additional antibiotics (eg, rifampin, vancomycin, penicillin, ampicillin, chloramphenicol, imipenem, clindamycin, clarithromycin)

 

Ciprofloxacin 10-15 mg/kg intravenously every 12 hours*

OR

Doxycycline:
             > 8 years and > 45 kg:
                       100 mg intravenously every 12 hours
             > 8 years and < 45 kg:
                        2.2 mg/kg intravenously every 12 hours
             < 8 years:
                        2.2 mg/kg intravenously every 12 hours
                              PLUS (for either drug)
              One or two additional antibiotics

 


          

*Ciprofloxacin dose in children not to exceed 1 g/day

Adapted from References 18,19

  

This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.

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Copyright 2002 The Cleveland Clinic Foundation