This protocol covers empiric regimen selection for children aged 1 month to less than 18 years presenting with systemic anthrax via inhalation or pulmonary exposure — a scenario that may occur with or without concurrent meningitis.
The patient is a pediatric patient aged 1 month to under 18 years with systemic anthrax (inhalation/pulmonary). Concurrent meningitis may or may not be present. The pediatric age range and meningitis status directly inform which combination strategy is appropriate.
When the preferred regimen cannot be used, this protocol defines alternative combinations — ranked in descending order of preference — that pair a bactericidal agent with a protein synthesis inhibitor (PSI) or an RNA-inhibiting agent (RNAI), with antitoxin continuing as an adjunct. Further alternatives involving two agents from the same category are also ranked. The full ordered algorithm, specific agents, and regimen criteria are available in the complete protocol.
Empiric treatment regimens for children aged >1 month to <18 years with systemic anthrax with or without meningitis (Table 14) are summarized as follows: