Interim recommendations, MMWR 50(no 41):893 Oct 19,2001, for postexposure prophylaxis to prevent inhalational anthrax after exposure to B. anthracis spores recommend ciprofloxacin or doxycycline as initial therapy in situations associated with the current bioterrorist attack in the United States.
EFFECTIVENESS: There is no evidence which demonstrates that ciprofloxacin is more or less effective than doxycycline for postexposure prophylaxis for prevention of infection with B. anthracis
RESISTANCE: Widespread use of any antibiotic will promote resistance. Many common pathogens are already resistant to tetracyclines such as doxycycline. However, ciprofloxacin resistance is not yet common in these same organisms. To preserve the effectiveness of ciprofloxacin against other infections, use of doxycycline for prevention of B. anthracis infection is reasonable. Ciprofloxacin is an effective antimicrobial for a variety of other bacterial infections. Thus, the wide use of this drug in thousands of individuals may lead to increased resistance of other bacterial pathogens to ciprofloxacin and other fluroquinolones, and limit the usefulness of these agents.
SIDE EFFECTS: On the basis of side-effect profiles (see below), the history of reactions, or the clinical setting, either doxycycline or ciprofloxacin may be preferable for an individual patient.
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Source: U.S. Government Website |