How is anthrax treated?

Bed rest until the temperature returns to normal. Diet - table No. 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 the existing clinical and laboratory syndromes. Etiotropic treatment of anthrax is presented in the treatment regimens for different forms of the disease.

Scheme of application of antibacterial drugs for treatment of anthrax (cutaneous form with mild course)

Preparation	Directions for use	Single dose, g	Frequency of use per day	Duration of the course, days
Ampicillin	Inside	0.5	4	7
Doxycycline	Inside	0.2	2	7
Rifampicin	Inside	0.45	2	7
Pefloxacin	Inside	0.4	2	7
Ofloxacin	Inside	0.2	3	7
Ciprofloxacin	Inside	0.25-0.75	2	7
Benzylpenicillin	V/m	1 million units	4	7
Gentamicin	V/m	0.08	3	7
Amikacin	V/m	0.5	2	7
Levomycetin sodium succinate	I/V	70-100 mg/kg	1	7

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

Preparation	Directions for use	Single dose, g	Frequency of use per day	Duration of the course, days
Benzylpenicillin	I/m, IV	1 million units	6	14-21
Ampicillin	V/m	2-3	4	14
Rifampicin	I/m, IV	0.3	2	14-21
Doxycycline	I/V	0.2	2	10-14
Gentamicin	I/m, IV	0.16	2-3	10
Amikacin	I/m, IV	0.5	2	10
Ciprofloxacin	I/V	0.2	2	10
Pefloxacin	I/V	0.4	2	10
Rifampicin Ampicillin	I/m, IV I/V	0.45 2	1 4	14 14
Rifampicin + Doxycycline	I/m, IV I/V	0.45 0.2	1 1	14 14

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

Categories of victims	Initial therapy (intravenous administration)	Duration of the course, days
Adults	Ciprofloxacin 500 mg every 12 hours or doxycycline 100 mg every 12 hours and one or two additional antimicrobials	Start with intravenous administration, then oral administration, 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:	Start with intravenous administration, then oral administration every 12 hours, depending on the clinical course: ciprofloxacin at a dose of 10-15 mg/kg body weight or doxycycline:
over 8 years of age with a body weight of more than 45 kg	100 mg each	100 mg each
over 8 years of age with a body weight of 45 kg or less	at 2.2 mg/kg	at 2.2 mg/kg
Ages 8 and under	2.2 mg/kg - 1-2 additional antimicrobial drugs	2.2 mg/kg Duration 6 days
Pregnant women	Same as for other adults, High mortality outweighs the risk of complications from antibiotic therapy	They start with intravenous administration, then oral administration, depending on the clinical course: the regimens are the same as for other adults.
Persons with immunodeficiency conditions	The same as for adults and children without immunodeficiency	The same as for adults and children without immunodeficiency

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

Categories of victims	Initial therapy (oral administration)	Duration of the course, days
Adults	Ciprofloxacin 500 mg twice daily or doxycycline 100 mg twice daily	6
Children	Ciprofloxacin 10-15 mg/kg body weight every 12 hours or doxycycline every 12 hours.	6
over 8 years of age with a body weight of more than 45 kg	100 mg each
over 8 years of age with a body weight of 45 kg or less	at 2.2 mg/kg
Ages 8 and under	2.2 mg/kg
Pregnant women	Ciprofloxacin 500 mg twice daily or doxycycline 100 mg twice daily	6 days
Persons with immunodeficiency conditions	The same as for adults and children without immunodeficiency.	6 days

Etiotropic treatment of anthrax should be combined with a single administration of specific anti-anthrax immunoglobulin at a dose of 20-100 ml intramuscularly (the dose depends on the severity of the condition). Local therapy consists only of treating the affected areas of the skin with antiseptic solutions. Bandages are not applied. Surgical intervention is contraindicated, since it contributes to the generalization of the infection. In the development of infectious toxic shock, widespread edema of the face and neck, it is recommended to administer prednisolone at a dose of 90-240 mg. Detoxification therapy is carried out according to individual indications. In the generalized form of the disease, antibiotic therapy is combined with intensive detoxification, measures aimed at combating hemodynamic disorders. Intravenous perfusions of polyionic solutions are 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 hemodez. Oxygen therapy, hyperbaric oxygenation, and extracorporeal detoxification methods are used.

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Approximate periods of incapacity for work

Discharge of recovering patients with cutaneous anthrax is carried out after the rejection of the scab and the formation of a scar. Patients who have suffered from generalized forms of the disease are discharged after complete clinical recovery and two negative results of bacteriological studies, carried out at intervals of 5 days. Dispensarization is not regulated.

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