How is anthrax treated?

Mode - bed rest before temperature normalization. Diet - table number 13, in severe cases - enteral-parenteral nutrition. Treatment of anthrax includes etiotropic and pathogenetic therapy, carried out depending on the form of the disease and available clinical and laboratory syndromes. Etiotropic treatment of anthrax is presented in the treatment regimens of various forms of the disease.

Scheme of the use of antibacterial drugs for the treatment of anthrax (dermal form with a light course)

A drug	Mode of application	Single dose, g	Multiplicity of application in days	Duration of the course, day
Ampicillin	Inside	0.5	4	7th
Doxycycline	Inside	0.2	2	7th
Rifampicin	Inside	0.45	2	7th
Pefloxacin	Inside	0.4	2	7th
Ofloxacin	Inside	0.2	3	7th
Ciprofloxacin	Inside	0.25-0.75	2	7th
Benzylpenicillin	In / m	1 million units	4	7th
Gentamicin	In / m	0.08	3	7th
Amikacin	In / m	0.5	2	7th
Levomycetin sodium succinate	In / in	70-100 mg / kg	1	7th

Scheme of antibacterial drugs in the treatment of anthrax (severe course)

A drug	Mode of application	Single dose, g	Multiplicity of application per day	Duration of the course, day
Benzylpenicillin	V / m, in / in	1 million units	6th	14-21
Ampicillin	In / m	2-3	4	14
Rifampicin	V / m, in / in	0.3	2	14-21
Doxycycline	In / in	0.2	2	10-14
Gentamicin	V / m, in / in	0.16	2-3	10
Amikacin	V / m, in / in	0.5	2	10
Ciprofloxacin	In / in	0.2	2	10
Pefloxacin	In / in	0.4	2	10
Rifampicin Ampicillin	V / m, in / in In / in	0.45 2	1 4	14 14
Rifampicin + Doxycycline	V / m, in / in In / in	0.45 0.2	1 1	14 14

Schemes for the use of antibacterial drugs in the treatment of an inhalation form of anthrax in cases of acts of biological terrorism

Victim categories	Initial therapy (intravenous administration)	Duration of the course, day
Adults	Ciprofloxacin 500 mg every 12 hours or doxycycline 100 mg every 12 hours and one or two additional antimicrobials	Begin with intravenous administration, then intake, depending on the clinical course: ciprofloxacin 500 mg twice a day or doxycycline 100 mg twice a day. Duration 6 days
Children	Every 12 hours ciprofloxacin at a dose of 10-15 mg / kg body weight or doxycycline:	Begin with intravenous administration, then ingestion every 12 hours, depending on the clinical course: ciprofloxacin at a dose of 10-15 mg / kg body weight or doxycycline:
at the age of over 8 years with a body weight of more than 45 kg	for 100 mg	for 100 mg
aged over 8 years with a body weight of 45 kg and less	at 2.2 mg / kg	at 2.2 mg / kg
At the age of 8 years and younger	At 2.2 mg / kg - 1-2 additional antimicrobial preparations	At 2.2 mg / kg Duration 6 days
Pregnant	The same. As for the rest of adults, High mortality exceeds the risk of complications of antibiotic therapy	Begin with intravenous administration, then intake, depending on the clinical course: the schemes are the same as for the remaining adults
Persons with immunodeficiency states	Same as for adults and children without immunodeficiency	Same as for adults and children without immunodeficiency

Scheme of antibacterial drugs in the treatment of cutaneous anthrax in cases of acts of biological terrorism

Victim categories	Initial therapy (ingestion)	Duration of the course, day
Adults	Ciprofloxacin 500 mg twice daily or doxycycline 100 mg twice daily	6th
Children	Ciprofloxacin 10-15 mg kg body weight every 12 hours or doxycycline every 12 hours.	6th
at the age of over 8 years with a body weight of more than 45 kg	for 100 mg
aged over 8 years with a body weight of 45 kg and less	at 2.2 mg / kg
At the age of 8 years and younger	At 2.2 mg / kg
Pregnant	Ciprofloxacin 500 mg twice daily or doxycycline 100 mg twice daily	6 days
Persons with immunodeficiency states	The same. As for adults and children without immunodeficiency	6 days

Etiotropic treatment of anthrax should be combined with a single administration of a specific anti-STI immunoglobulin at a dose of 20-100 ml intramuscularly (the dose depends on the severity of the condition). Local therapy consists only in the treatment of affected skin with solutions of antiseptics. Bandages do not impose. Surgical intervention is contraindicated because it promotes generalization of the infection. With the development of infectious-toxic shock, widespread edema of the face and neck, it is recommended to administer prednisolone in a dose of 90-240 mg. According to individual indications, detoxification therapy is carried out. In the generalized form of the disease, antibiotic therapy is combined with intensive detoxification, measures aimed at combating hemodynamic disorders. Intravenous perfusion of polyionic solutions is used in the volume necessary to restore the volume of circulating blood, microcirculation, water-electrolyte balance (2-5 L), daily with the addition of 100 ml of polyglucin, rheopolyglucin or gemodeza. Oxygenotherapy, hyperbaric oxygenation, extracorporeal detoxification methods are used.

[1], [2], [3], [4], [5],

Approximate terms of incapacity for work

The recovery of patients recovering from the skin form of anthrax is carried out after the removal of the scab and formation of a scar. Patients who have transferred generalized forms of the disease are discharged after complete clinical recovery and a twofold negative result of bacteriological studies conducted at intervals of 5 days. Examination is not regulated.

[6], [7], [8],