מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – With the threat of new anthrax cases still looming, The New England Journal of Medicine has released a paper from the November 29th issue, highlighting the recognition and management of anthrax infection.
In his article, Dr. Morton N. Swartz from Massachusetts General Hospital in Boston reviews the bacteriology, pathogenesis and epidemiology of anthrax. In addition to discussing the now-familiar inhalation and cutaneous manifestations of anthrax, Dr. Swartz also describes gastrointestinal anthrax and anthrax meningitis.
Anthrax can be detected by in-hospital laboratory testing of Gram's stained smear of a skin lesion, cerebrospinal fluid or blood, Dr. Swartz points out. Test results usually take from 24 to 48 hours, he told Reuters Health..
In terms of treatment, "the anthrax isolates that were found in Florida, Washington DC and New Jersey had an inducible beta-lactamase, which can degrade penicillin. So penicillin should not be used alone for treatment but should be combined with other drugs," Dr. Swartz noted.
First line treatment for adults is ciprofloxacin 500 mg orally every 12 hours for prophylaxis, or 400 mg IV every 12 hours for those with inhalation anthrax, according to the review. For children, the prophylaxis dose should be 10 to 15 mg/kg of body weight ciprofloxacin orally every 12 hours, and 20 to 30 mg/kg of body weight IV in two daily doses for inhalation anthrax.
Other fluoroquinolones and doxycycline are also recommended for use along with ciprofloxacin, Dr. Swartz advises.
When treating anthrax patients, Dr. Swartz recommends taking standard universal precautions. Any drainage from open lesions should be dressed with sterile dressings, he added.
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