Dear Mr. Rawles,
I have just one brief addition to Dr. Bob’s excellent synopsis of the dangers of anthrax regarding treatment/prevention with antibiotics. First, I must commend Dr. Bob on all of his important advice, and for his courage to offer a much needed service (the prescribing of antibiotics in advance of need) in this highly litigious society.
Understanding that in TEOTWAWKI our current risk:benefit analysis will be drastically changed, and short-course antibiotic therapy may be all that is available to us, I felt compelled to mention the current CDC recommendations regarding duration of therapy. Antibiotic use in inhaled anthrax is slightly different in prophylaxis (prevention of the disease in those who have been exposed, but are yet to display symptoms) and in treatment (those who have already begun the flu-like symptoms described by Dr. Bob).
The adult prophylactic regimen recommended consists of oral ciprofloxacin 500mg twice daily or oral doxycycline 100mg twice daily taken for 60 days. For treatment of anthrax, either of the two above agents should be started via intravenous administration (cipro dose is 400mg twice daily, doxy dose is the same as oral) in combination with another intravenous agent, such as clindamycin 900mg every 8 hours. As the patient’s condition improves, the oral route of administration may be substituted, and it may be possible to discontinue the additional antibiotic (in this example, clindamycin). Again, the total therapy should be continued for 60 days. Other antibiotic combinations are recommended as alternatives, but these are the most commonly cited and are available generically, that is, they are affordable.
Obviously, intravenous administration will be impossible for most folks if the Schumer hits the fan, so we may have to do the best we can with oral administration – which should stand a decent chance of success if the patient is well enough to swallow and has a functional gut, as most of these drugs are well-absorbed from the GI tract. The uncommonly long duration of therapy is a function of the life cycle of Bacillus anthracis, the causative organism of anthrax. The inhaled spores typically germinate into the toxin-producing bacterium within 7 days; however, some take longer. I am not an infectious disease specialist, nor a medical microbiologist, but I suspect that the 60 day antibiotic recommendation is a bit on the safe side. If the emergency need arises and organized health care is not available, any duration of antibiotic therapy beyond 7 days would certainly be better than nothing. The committed prepper should, however, be aware of the possible need for considerably more antibiotics than the typical 7-10 day course of therapy would call for.
Again, many thanks to Dr. Bob for his frequent contributions to SurvivalBlog! - S.H. in Georgia