By Emma Hitt, PhD
ATLANTA (Reuters Health) – Adverse reactions to anthrax antimicrobial prophylaxis, mostly with ciprofloxacin, are being reported by about 20% of those taking it, according to the US Centers for Disease Control and Prevention (CDC).
As reported in the November 9th issue of the CDC's Morbidity and Mortality Weekly Report, 1132 persons at American Media Inc. in Boca Raton, Florida received antimicrobial prophylaxis for presumed exposure to B. anthracis, after the first case of inhalation anthrax was documented there. Of those, 970 received ciprofloxacin.
After 14 days, 80% were still taking antibiotics. To assess adverse events, a questionnaire was administered to 490 of those still taking antibiotics on or around day 7 or day 14. The responses to the questionnaire indicated that 95 (19%) of the 490 respondents reported one or more adverse reactions, in the form of itching, breathing problems or swelling of face, neck, or throat.
Record review and telephone interviews of the 95 people experiencing adverse events indicated that six persons sought medical attention and did not continue taking their original medication, possibly because of adverse events.
The CDC points out that adverse events have not been well described among individuals taking ciprofloxacin or doxycycline for extended periods. "Because many persons are receiving antimicrobial prophylaxis, enhanced surveillance programs are essential to detect and monitor adverse events associated with these medications," they suggest.
Since October 8th, approximately 32,000 persons have initiated antimicrobial prophylaxis against anthrax, and about 5000 have been advised to take a 60-day course.
MMWR 2001;50:973-976.
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