Intravenous (IV) therapy a, b, c, d

Ciprofloxacin, 400 mg every 12 hours or Doxycycline, 100 mg every 12 hours

                                                  AND

1 to 2 additional appropriate antibiotics e

Oral therapy c, d, f

Ciprofloxacin, 500 mg orally every 12 hours

Alternate Therapy if proven susceptible strain

Doxycycline, 100 mg orally every 12 hours

Amoxicillin, 500 mg orally every 8 hours **

* modified from Inglesby TV et. al., Anthrax as a biological weapon, 2002: updated recommendations for management [30] and MMWR: Morb Mortal Wkly Rep. [72]
aIntravenous and combination therapy preferred to oral therapy alone bInitial IV therapy may be switched to susceptible oral therapy when clinically appropriate cTotal duration of therapy should be 60 days dFor pregnant women and immunocompromised hosts, initial IV and oral antibiotic recommendations are the same as the general population eAntibiotics with in vitro activity against B. anthracis include rifampin, vancomycin, penicillin, ampicillin [226], imipenem [227], chloramphenicol, and clarithromycin [228]. Consultation with an infectious disease specialist is recommended fInitial oral therapy should be used in situations where intravenous therapy is not available or limited in supply ** CDC recommends the use of amoxicillin for post exposure prophylaxis only after 10-14 days of therapy with Doxycycline or fluoroquinolones and only if there is a contraindication to the use of these drugs
Table 1: E. Recommended initial antibiotic therapy for individuals suspected of inhalational anthrax.