Postexposure Prophylaxis and Treatment of Bacillus anthracis Infections: A Systematic Review and Meta-analyses of Animal Models, 1947-2019.
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Clinical Guidelines
Authored By
Kennedy JL, Bulitta JB, Chatham-Stephens K, Person MK, Cook R, Mongkolrattanothai T, Shin E, Yu P, Negron ME, Bower WA, Hendricks K
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Infectious Disease & Vaccines
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Infectious Disease & Vaccines
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volume
75
ISSN
1537-6591
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{"article_title":"Postexposure Prophylaxis and Treatment of Bacillus anthracis Infections: A Systematic Review and Meta-analyses of Animal Models, 1947-2019.","author":"\"Kennedy, Jordan L , Bulitta, J\u00fcrgen B , Chatham-Stephens, Kevin , Person, Marissa K , Cook, Rachel , Mongkolrattanothai, Thitipong , Shin, Eunjeong , Yu, Patricia , Negron, Maria E , Bower, William A , Hendricks, Katherine\"","journal_title":"Clinical infectious diseases : an official publication of the Infectious Diseases Society of America","issn":"1537-6591 ; Electronic","isbn":"","publication_date":"20221017","volume":"75","issue":"Suppl 3","first_page":"S379","page_count":"","accession_number":"36251546","doi":"10.1093\/cid\/ciac591","publisher":"Oxford University Press","doctype":"Journal Article; Meta-Analysis; Systematic Review","subjects":"Pharmacology ","interest_area":["Infectious Disease & Vaccines"],"abstract":"Anthrax is endemic to many countries, including the United States. The causative agent, Bacillus anthracis, poses a global bioterrorism threat. Without effective antimicrobial postexposure prophylaxis (PEPAbx) and treatment, the mortality of systemic anthrax is high. To inform clinical guidelines for PEPAbx and treatment of B. anthracis infections in humans, we systematically evaluated animal anthrax treatment model studies.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=36251546&authtype=shib&custid=ns346513","isPdfLink":true,"isSAML":false,"additionalInfo":{"Authored_By":"Kennedy JL, Bulitta JB, Chatham-Stephens K, Person MK, Cook R, Mongkolrattanothai T, Shin E, Yu P, Negron ME, Bower WA, Hendricks K","Journal_Info":"Publisher: Oxford University Press Country of Publication: United States NLM ID: 9203213 Publication Model: Print Cited Medium: Internet ISSN: 1537-6591 (Electronic) Linking ISSN: 10584838 NLM ISO Abbreviation: Clin Infect Dis Subsets: MEDLINE","Publication_Type":"Journal Article; Meta-Analysis; Systematic Review; Research Support, U.S. Gov't, P.H.S.","Published_Date":"2022-10-17","Source":"Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2022 Oct 17; Vol. 75 (Suppl 3), pp. S379-S391.","Languages":"English","Electronic_ISSN":"1537-6591","MeSH_Terms":"Anthrax*\/drug therapy , Anthrax*\/prevention & control , Anti-Infective Agents*\/therapeutic use , Bacillus anthracis*, Amoxicillin-Potassium Clavulanate Combination\/therapeutic use ; Animals ; Anti-Bacterial Agents\/pharmacology ; Cilastatin, Imipenem Drug Combination\/pharmacology ; Cilastatin, Imipenem Drug Combination\/therapeutic use ; Ciprofloxacin\/therapeutic use ; Doxycycline\/therapeutic use ; Glycopeptides\/pharmacology ; Glycopeptides\/therapeutic use ; Humans ; Levofloxacin\/therapeutic use ; Lipopeptides\/pharmacology ; Lipopeptides\/therapeutic use ; Models, Animal ; Tetracyclines\/therapeutic use ; United States ; beta-Lactams\/therapeutic use","Subjects":"Amoxicillin-Potassium Clavulanate Combination therapeutic use, Animals, Anti-Bacterial Agents pharmacology, Cilastatin, Imipenem Drug Combination pharmacology, Cilastatin, Imipenem Drug Combination therapeutic use, Ciprofloxacin therapeutic use, Doxycycline therapeutic use, Glycopeptides pharmacology, Glycopeptides therapeutic use, Humans, Levofloxacin therapeutic use, Lipopeptides pharmacology, Lipopeptides therapeutic use, Models, Animal, Tetracyclines therapeutic use, United States, beta-Lactams therapeutic use, Anthrax drug therapy, Anthrax prevention & control, Anti-Infective Agents therapeutic use, Bacillus anthracis","Title_Abbreviations":"Clinical infectious diseases : an official publication of the Infectious Diseases Society of America","Volume":"75"},"header":{"DbId":"mdl","DbLabel":"MEDLINE Ultimate","An":"36251546","RelevancyScore":"871","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"870.961669921875"},"plink":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=36251546&authtype=shib&custid=ns346513&group=main&profile=eds","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=36251546&authtype=shib&custid=ns346513&group=main&profile=eds"}
["Kennedy JL, Bulitta JB, Chatham-Stephens K, Person MK, Cook R, Mongkolrattanothai T, Shin E, Yu P, Negron ME, Bower WA, Hendricks K","Publisher: Oxford University Press Country of Publication: United States NLM ID: 9203213 Publication Model: Print Cited Medium: Internet ISSN: 1537-6591 (Electronic) Linking ISSN: 10584838 NLM ISO Abbreviation: Clin Infect Dis Subsets: MEDLINE","Journal Article; Meta-Analysis; Systematic Review; Research Support, U.S. Gov't, P.H.S.","2022-10-17","Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2022 Oct 17; Vol. 75 (Suppl 3), pp. S379-S391.","English","1537-6591","Anthrax*\/drug therapy , Anthrax*\/prevention & control , Anti-Infective Agents*\/therapeutic use , Bacillus anthracis*, Amoxicillin-Potassium Clavulanate Combination\/therapeutic use ; Animals ; Anti-Bacterial Agents\/pharmacology ; Cilastatin, Imipenem Drug Combination\/pharmacology ; Cilastatin, Imipenem Drug Combination\/therapeutic use ; Ciprofloxacin\/therapeutic use ; Doxycycline\/therapeutic use ; Glycopeptides\/pharmacology ; Glycopeptides\/therapeutic use ; Humans ; Levofloxacin\/therapeutic use ; Lipopeptides\/pharmacology ; Lipopeptides\/therapeutic use ; Models, Animal ; Tetracyclines\/therapeutic use ; United States ; beta-Lactams\/therapeutic use","Amoxicillin-Potassium Clavulanate Combination therapeutic use, Animals, Anti-Bacterial Agents pharmacology, Cilastatin, Imipenem Drug Combination pharmacology, Cilastatin, Imipenem Drug Combination therapeutic use, Ciprofloxacin therapeutic use, Doxycycline therapeutic use, Glycopeptides pharmacology, Glycopeptides therapeutic use, Humans, Levofloxacin therapeutic use, Lipopeptides pharmacology, Lipopeptides therapeutic use, Models, Animal, Tetracyclines therapeutic use, United States, beta-Lactams therapeutic use, Anthrax drug therapy, Anthrax prevention & control, Anti-Infective Agents therapeutic use, Bacillus anthracis","Clinical infectious diseases : an official publication of the Infectious Diseases Society of America","75"]
Description
Background: Anthrax is endemic to many countries, including the United States. The causative agent, Bacillus anthracis, poses a global bioterrorism threat. Without effective antimicrobial postexposure prophylaxis (PEPAbx) and treatment, the mortality of systemic anthrax is high. To inform clinical guidelines for PEPAbx and treatment of B. anthracis infections in humans, we systematically evaluated animal anthrax treatment model studies.<br />Methods: We searched for survival outcome data in 9 scientific search engines for articles describing antimicrobial PEPAbx or treatment of anthrax in animals in any language through February 2019. We performed meta-analyses of efficacy of antimicrobial PEPAbx and treatment for each drug or drug combination using random-effects models. Pharmacokinetic/pharmacodynamic relationships were developed for 5 antimicrobials with available pharmacokinetic data. Monte Carlo simulations were used to predict unbound drug exposures in humans.<br />Results: We synthesized data from 34 peer-reviewed studies with 3262 animals. For PEPAbx and treatment of infection by susceptible B. anthracis, effective monotherapy can be accomplished with fluoroquinolones, tetracyclines, β-lactams (including penicillin, amoxicillin-clavulanate, and imipenem-cilastatin), and lipopeptides or glycopeptides. For naturally occurring strains, unbound drug exposures in humans were predicted to adequately cover the minimal inhibitory concentrations (MICs; those required to inhibit the growth of 50% or 90% of organisms [MIC50 or MIC90]) for ciprofloxacin, levofloxacin, and doxycycline for both the PEPAbx and treatment targets. Dalbavancin covered its MIC50 for PEPAbx.<br />Conclusions: These animal studies show many reviewed antimicrobials are good choices for PEPAbx or treatment of susceptible B. anthracis strains, and some are also promising options for combating resistant strains. Monte Carlo simulations suggest that oral ciprofloxacin, levofloxacin, and doxycycline are particularly robust choices for PEPAbx or treatment.<br /> (Published by Oxford University Press on behalf of Infectious Diseases Society of America 2022.)
