Table 9.

Summary of Findings From This Anthrax Treatment Systematic Review

Patient scenario	Recommendation
Dermal or ingestion exposure to Bacillus anthracis	Postexposure prophylaxis has been shown to reduce risk of anthrax
Localized cutaneous anthrax	Antimicrobial monotherapy is highly effective. Penicillin may be used as monotherapy if susceptibilities are known
Systemic anthrax without meningitis	Treatment with ≥1 bactericidal antimicrobials, with or without a protein synthesis inhibitor, is effective
Inhalation anthrax without meningitis	Combination therapy improves survival
Systemic anthrax, regardless of meningitis status	Treatment with ≥1 bactericidal antimicrobials is preferable to treatment with ≥1 protein synthesis inhibitors
	Addition of antitoxin/antiserum to antimicrobial treatment has not been shown to improve or decrease survival
Any type of anthrax	Steroids for nonmeningitis indications have not been shown to improve or decrease survival
Anthrax meningitis	Mannitol appears to improve survival
	Steroids might improve survival