Thursday October 25 12:57 PM ET

Gov't. Releases Anthrax Guidelines

By ERIN McCLAM, Associated Press Writer

ATLANTA (AP) - The government issued specific guidelines Thursday for treating anthrax, providing doctors a list of drugs beyond the sought-after antibiotic Cipro to help fight the infection.

But the Centers for Disease Control and Prevention (news - web sites), which scrambled to publish the guidelines as the nation's bioterrorism toll mounted, warned there are no human studies to back up the recommendations.

The guidelines apply only to confirmed cases of anthrax, not as a precaution for people who may have been exposed.

The CDC advised doctors to treat inhaled anthrax - the deadliest form - with a 60-day regimen starting with intravenous doses of Cipro or doxycycline, supplemented by one or two of seven additional drugs.

Those additional drugs include rifampin, commonly used to treat tuberculosis, and the medical stalwart penicillin. Drugs widely used to combat staph and other respiratory infections were also on the list.

Cipro, marketed by Bayer Corp., has received the most attention as the anthrax investigation has widened. Doses have been dispensed to thousands of people, from postal workers to NBC anchor Tom Brokaw, who may have been exposed to the bacteria.

Six cases of inhaled anthrax have been reported since the nation's mailborne anthrax crisis began. Two postal workers in Washington and a Florida tabloid editor have died.

The treatment guidelines came in the CDC's Morbidity and Mortality Weekly Report, the health bulletin that clinicians nationwide examine for details on outbreak investigations and guidelines for preventing disease.

``This is the first bioterrorism-related anthrax attack in the United States, and the public health ramifications of this attack continue to evolve,'' the bulletin cautioned.

For cases of cutaneous anthrax, the skin form of the disease, CDC also recommended 60 days of treatment with Cipro or doxycycline, but said the additional drugs are not necessary.

The same drugs are recommended for treating anthrax in adults and children, the agency said, with much smaller doses for children.

The CDC acknowledged some of the drugs may cause problems for pregnant women but did not alter the recommendations, saying the high death rate for inhalation anthrax far outweighs the risk associated with drugs to treat it.

For the inhalation form of anthrax, the drugs recommended as a supplement to Cipro or doxycycline are:

-Rifampin, also used to treat tuberculosis.

-Vancomycin, also used to treat staph infections.

-Imipenem, used to treat a variety of bacterial infections.

-Chloramphenicol, also used to treat infections that damage the liver.

-Penicillin, also used to treat a broad range of infections, including Lyme disease, tetanus and syphilis.

-Clindamycin, also used to treat acne.

-Clarithromycin, also prescribed to treat bacterial respiratory infections, like strep throat and pneumonia.

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On the Net:

CDC bioterrorism page: http://www.bt.cdc.gov

-- Anonymous, October 25, 2001