Antimicrobial postexposure prophylaxis for anthrax: adverse events and adherence.
We collected data during postexposure antimicrobial prophylaxis campaigns and from a prophylaxis program evaluation 60 days after start of antimicrobial prophylaxis involving persons from six U.S. sites where Bacillus anthracis exposures occurred. Adverse events associated with antimicrobial prophylaxis to prevent anthrax were commonly reported, but hospitalizations and serious adverse events as defined by Food and Drug Administration criteria were rare. Overall adherence during 60 days of antimicrobial prophylaxis was poor (44%), ranging from 21% of persons exposed in the Morgan postal facility in New York City to 64% of persons exposed at the Brentwood postal facility in Washington, D.C. Adherence was highest among participants in an investigational new drug protocol to receive additional antibiotics with or without anthrax vaccine--a likely surrogate for anthrax risk perception. Adherence of <60 days was not consistently associated with adverse events.
Shepard
Colin W
CW
Centers for Desease Control and Prevention , Atlanta, Georgia 30333, USA. cvc8@cdc.gov
Soriano-Gabarro
Montse
M
Zell
Elizabeth R
ER
Hayslett
James
J
Lukacs
Susan
S
Goldstein
Susan
S
Factor
Stephanie
S
Jones
Joshua
J
Ridzon
Renee
R
Williams
Ian
I
Rosenstein
Nancy
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000881:Anthrax / Q000188:drug therapy* / Q000517:prevention & control*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D023482:Bioterrorism; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004219:District of Columbia; D004318:Doxycycline / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D010349:Patient Compliance; D010406:Penicillins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D012307:Risk Factors; D016312:Treatment Refusal
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D010406:Penicillins; D002939:Ciprofloxacin; D000658:Amoxicillin; D004318:Doxycycline