If fluoroquinolones are not available or are contraindicated, doxycycline is used. Children should receive prophylaxis with oral ciprofloxacin or oral doxycycline. Use of tetracyclines and fluoroquinolones in children has adverse effects that need to be considered carefully against the risk for life-threatening disease. Prophylaxis should be continued until B. anthracis exposure has been excluded. If exposure is confirmed, prophylaxis should continue for four weeks and until three doses of anthrax vaccine have been given or for eight weeks if vaccine is not available.
Vaccination is indicated in conjunction with chemoprophylaxis following a proven biologic incident.
Postexposure vaccination consists of three injections, with one given as soon as possible after exposure and the others given at two and four weeks after exposure. The report in MMWR summarizes the findings of the investigations of the recent threats of anthrax exposure. It also covers the methods by which health professionals and public health departments should address bioterrorism and develop locality-specific response plans. The device, Prosorba column, is indicated for use in the therapeutic reduction of the signs and symptoms of moderate to severe rheumatoid arthritis in adults with longstanding disease and who have failed or are intolerant of disease-modifying antirheumatic drugs. In this treatment, the patient's blood is removed and passed through a machine that separates the blood cells from the plasma.