Table 3.

Antibiotics recommended for treatment of anthrax in adults and children

Antibiotic*	Adults	Children
Ciprofloxacin	500 mg twice a day	20–30 mg/kg/day divided into 2 doses (maximum dose, 1000 mg/day)†
	IV: 400 mg every 12 hours	IV: 10 mg/kg (max 400 mg) every 12 hours
Levofloxacin	500 mg a day	Not recommended
Ofloxacin	400 mg twice a day	Not recommended
Doxycycline	200 mg, then 100 mg twice a day	2.5 mg/kg every 12 hours; daypatients ≫45 kg should receive adult dose†
Penicillin G	4 million U every 4 hours	400,000 U/kg/day divided into 4 doses‡
Amoxicillin	3 g 3 times a day	2 g in a 24-hour period (<3 months: maximum 30 mg/kg/day)

*Quinolones and doxycycline can be delivered orally or intravenously.

†Pediatric use of fluoroquinolones is associated with adverse effects that must be weighed against the risk of a lethal disease. Penicillin is the drug of choice for susceptible strains.

‡Alternative pediatric dose for penicillin G: age <12 years: 50,000 U/kg every 6 hours; age ≫12 years: 4 million U every 4 hours.