This protocol applies to pediatric patients aged >1 month to <18 years with systemic anthrax acquired via the inhalation (pulmonary) route. Meningeal involvement may or may not be present, and the treatment framework accounts for both presentations.
When the preferred treatment combination cannot be used, structured alternative regimens are available — in descending order of preference — each pairing agents from different antimicrobial drug classes, with antitoxin continuing as an adjunct throughout.
Empiric treatment regimens for children aged >1 month to <18 years with systemic anthrax with or without meningitis (Table 14) are summarized as follows:
If an appropriate combination of bactericidal drug plus a PSI or an RNAI is contraindicated, not well tolerated, or not available for treatment of noncutaneous systemic anthrax, consider the following regimens in descending order of preference.
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