Naturally occurring cutaneous anthrax: antibiotic treatment and outcome

Chemotherapy. 2012;58(1):34-43. doi: 10.1159/000335593. Epub 2012 Feb 10.

Abstract

Objectives: Cutaneous anthrax (CA) is the most common clinical presentation in human anthrax, but the duration of antibiotic therapy in naturally occurring CA is controversial. The aim of this study was to compare the clinical outcomes of patients receiving antibiotic treatment for either 3-5 days (group 1) or 7-10 days (group 2) in uncomplicated CA.

Methods: A total of 66 patients were enrolled; 29 (44%) in group 1 and 37 (56%) in group 2. Infections were classified as mild (n = 22, 33%) or severe (n = 44, 67%) CA.

Results: There were no significant differences between the groups in symptom resolution time, fever clearance time, healing of lesions, development and healing of eschars, requirement for surgical intervention or the development of complications. Both edema resolution time and duration of hospital stay were longer in group 2. There were no therapeutic failures, relapses or deaths in either group. Steroid therapy was used in 32% of patients with severe CA, but a beneficial effect on resolution of edema was not demonstrated.

Conclusions: These results suggest that short-course antibiotic therapy is as effective as standard-duration therapy in uncomplicated CA and that steroid therapy may not be effective.

Publication types

  • Controlled Clinical Trial
  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Amoxicillin / therapeutic use
  • Anthrax / drug therapy*
  • Anthrax / pathology
  • Anti-Bacterial Agents / therapeutic use*
  • Ciprofloxacin / therapeutic use
  • Doxycycline / therapeutic use
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Penicillin G Procaine / therapeutic use
  • Prospective Studies
  • Skin Diseases, Bacterial
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Penicillin G Procaine
  • Ciprofloxacin
  • Amoxicillin
  • Doxycycline

Supplementary concepts

  • Cutaneous anthrax