Hearing the word “anthrax” can trigger immediate fear and anxiety, largely due to its association with severe illness and public health emergencies. However, for those affected whether through rare contact with infected animals or environmental exposure, the condition is a treatable medical reality. Symptoms can range from a painless but alarming skin ulcer to severe respiratory distress, depending on how the bacteria entered the body. While the diagnosis is serious, modern medicine provides effective tools to fight the infection and support recovery.

Treatment is critical and time-sensitive. The primary goals are to kill the bacteria, neutralize the dangerous toxins they release, and manage symptoms to prevent organ damage. Because anthrax can manifest in different forms cutaneous (skin), inhalation (lung), gastrointestinal, or injection, treatment intensity varies. While a mild skin infection may be managed with oral medications, inhalation anthrax requires aggressive, hospital-based care. Decisions regarding the specific drug regimen depend on the route of infection and the patient’s overall stability (Centers for Disease Control and Prevention, 2022).

Overview of treatment options for Anthrax Infection

The medical management of anthrax relies on a dual approach: eliminating the bacteria and neutralizing the toxins. Antibiotics are the foundation of all treatment plans and are started immediately, often before lab results confirm the diagnosis if suspicion is high.

For systemic cases, such as inhalation anthrax, medications are typically administered intravenously (IV) in a hospital setting. In addition to killing the bacteria, doctors now have access to antitoxins, specialized medications that target the lethal poisons produced by the anthrax bacteria. This combination has significantly improved survival rates. Clinical experience suggests that the earlier treatment begins, the better the outcome, particularly for the more severe forms of the disease.

Medications used for Anthrax Infection

Antibiotics are the first-line defense. The most commonly prescribed drugs belong to the fluoroquinolone and tetracycline classes. Ciprofloxacin and doxycycline are the standard medications used for both treatment and post-exposure prevention. Levofloxacin is another frequently used fluoroquinolone.

For severe or inhalation anthrax, doctors typically use “multidrug regimens.” This involves combining ciprofloxacin or doxycycline with other antibiotics such as rifampin, vancomycin, or penicillin to attack the bacteria from multiple angles and overcome potential drug resistance.

The second critical class of medications is antitoxins (monoclonal antibodies). Drugs like raxibacumab and obiltoxaximab are designed specifically to neutralize the toxins released by Bacillus anthracis. These are usually administered as a single IV dose alongside antibiotics for patients with systemic anthrax.

Patients with cutaneous anthrax can expect skin lesions to heal over several weeks, though scarring is common. Those on preventative therapy (after exposure but before symptoms) typically take oral antibiotics for a full 60 days to ensure any lingering spores are eradicated (FDA, 2023).

How these medications work

Antibiotics like ciprofloxacin and doxycycline work by interfering with the bacteria’s ability to reproduce. Fluoroquinolones block the enzymes needed for bacterial DNA replication, while tetracyclines inhibit protein synthesis. By stopping the bacteria from multiplying, the immune system can clear the remaining infection.

Antitoxins work differently. Anthrax bacteria release three proteins that combine to form a lethal toxin, which enters human cells and causes massive damage and fluid buildup. Antitoxins act like “blockers” or “sponges” in the bloodstream. They bind to the protective antigen (one of the toxin components) before it can attach to human cells. This prevents the toxin from entering tissues and causing the catastrophic swelling and organ failure associated with severe anthrax (National Institutes of Health, 2022).

Side effects and safety considerations

Anthrax antibiotics have side effects. Ciprofloxacin and other fluoroquinolones may cause tendon issues, nerve symptoms (tingling/numbness), and sun sensitivity. Doxycycline often causes stomach upset and sun sensitivity.

Antitoxins are powerful biological drugs that can cause hypersensitivity reactions; patients are monitored for anaphylaxis (rash, low blood pressure, throat swelling).

In pregnancy, although some antibiotics are used with caution, severe anthrax often necessitates their use, as benefits outweigh risks. Patients must seek immediate care for severe diarrhea, joint pain, or breathing difficulty during treatment. Since everyone’s experience with the condition and its treatments can vary, working closely with a qualified healthcare provider helps ensure safe and effective care.

References

  1. Centers for Disease Control and Prevention. https://www.cdc.gov
  2. Food and Drug Administration. https://www.fda.gov
  3. National Institutes of Health. https://www.nih.gov
  4. Mayo Clinic. https://www.mayoclinic.org

Medications for Anthrax Infection

These are drugs that have been approved by the US Food and Drug Administration (FDA), meaning they have been determined to be safe and effective for use in Anthrax Infection.

Found 3 Approved Drugs for Anthrax Infection

Raxibacumab

Generic Name
Raxibacumab

Raxibacumab

Generic Name
Raxibacumab
Raxibacumab is indicated for the treatment of adult and pediatric patients with inhalational anthrax due to Bacillus anthracis in combination with appropriate antibacterial drugs, and for prophylaxis of inhalational anthrax when alternative therapies are not available or are not appropriate.

Anthim

Generic Name
Obiltoxaximab

Anthim

Generic Name
Obiltoxaximab
ANTHIM ® is a monoclonal antibody directed against the protective antigen of Bacillus anthracis. It is indicated in adult and pediatric patients for treatment of inhalational anthrax due to B. anthracis in combination with appropriate antibacterial drugs and, for prophylaxis of inhalational anthrax when alternative therapies are not available or are not appropriate.

Minocycline

Brand Names
ZILXI, Emrosi, Amzeeq, Arestin, Minocin

Minocycline

Brand Names
ZILXI, Emrosi, Amzeeq, Arestin, Minocin
Minocycline hydrochloride tablets, USP are indicated in the treatment of the following infections due to susceptible strains of the designated microorganisms: Rocky Mountain spotted fever, typhus fever and the typhus group, Q fever, rickettsialpox and tick fevers caused by rickettsiae. Respiratory tract infections caused by Mycoplasma pneumoniae. Lymphogranuloma venereum caused by Chlamydia trachomatis. Psittacosis (Ornithosis) due to Chlamydophila psittaci. Trachoma caused by Chlamydia trachomatis, although the infectious agent is not always eliminated, as judged by immunofluorescence. Inclusion conjunctivitis caused by Chlamydia trachomatis. Nongonococcal urethritis, endocervical, or rectal infections in adults caused by Ureaplasma urealyticum or Chlamydia trachomatis. Relapsing fever due to Borrelia recurrentis. Chancroid caused by Haemophilus ducreyi. Plague due to Yersinia pestis. Tularemia due to Francisella tularensis. Cholera caused by Vibrio cholerae. Campylobacter fetus infections caused by Campylobacter fetus. Brucellosis due to Brucella species (in conjunction with streptomycin). Bartonellosis due to Bartonella bacilliformis. Granuloma inguinale caused by Klebsiella granulomatis. Minocycline is indicated for the treatment of infections caused by the following gram-negative microorganisms when bacteriologic testing indicates appropriate susceptibility to the drug: Escherichia coli. Klebsiella aerogenes Shigella species. Acinetobacter species. Respiratory tract infections caused by Haemophilus influenzae. Respiratory tract and urinary tract infections caused by Klebsiella species. Minocycline hydrochloride tablets, USP are indicated for the treatment of infections caused by the following gram-positive microorganisms when bacteriologic testing indicates appropriate susceptibility to the drug: Upper respiratory tract infections caused by Streptococcus pneumoniae. Skin and skin structure infections caused by Staphylococcus aureus. (NOTE: Minocycline is not the drug of choice in the treatment of any type of staphylococcal infection.) When penicillin is contraindicated, minocycline is an alternative drug in the treatment of the following infections: Uncomplicated urethritis in men due to Neisseria gonorrhoeae and for the treatment of other gonococcal infections. Infections in women caused by Neisseria gonorrhoeae. Syphilis caused by Treponema pallidum subspecies pallidum. Yaws caused by Treponema pallidum subspecies pertenue. Listeriosis due to Listeria monocytogenes. Anthrax due to Bacillus anthraci s. Vincent’s infection caused by Fusobacterium fusiforme. Actinomycosis caused by Actinomyces israelii. Infections caused by Clostridium species. In acute intestinal amebiasis, minocycline may be a useful adjunct to amebicides. In severe acne, minocycline may be useful adjunctive therapy. Oral minocycline is indicated in the treatment of asymptomatic carriers of Neisseria meningitidis to eliminate meningococci from the nasopharynx. In order to preserve the usefulness of minocycline in the treatment of asymptomatic meningococcal carriers, diagnostic laboratory procedures, including serotyping and susceptibility testing, should be performed to establish the carrier state and the correct treatment. It is recommended that the prophylactic use of minocycline be reserved for situations in which the risk of meningococcal meningitis is high. Oral minocycline is not indicated for the treatment of meningococcal infection. Although no controlled clinical efficacy studies have been conducted, limited clinical data show that oral minocycline hydrochloride has been used successfully in the treatment of infections caused by Mycobacterium marinum. To reduce the development of drug-resistant bacteria and maintain the effectiveness of minocycline hydrochloride tablets, USP and other antibacterial drugs, minocycline hydrochloride tablets, USP should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
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