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Abstract：
Bacillus anthracis spores if resources become limited or a multidrug-resistant B. anthracis strain is used (Hendricks KA, Wright ME, Shadomy SV, et al.; Workgroup on Anthrax Clinical Guidelines. Centers for Disease Control and Prevention expert panel meetings on prevention and treatment of anthrax in adults. Emerg Infect Dis 2014;20:e130687; Meaney-Delman D, Rasmussen SA, Beigi RH, et al. Prophylaxis and treatment of anthrax in pregnant women. Obstet Gynecol 2013;122:885-900; Bradley JS, Peacock G, Krug SE, et al. Pediatric anthrax clinical management. Pediatrics 2014;133:e1411-36). Specifically, this report updates antimicrobial drug and antitoxin use for both postexposure prophylaxis (PEP) and treatment from these previous guidelines best practices and is based on systematic reviews of the literature regarding 1) in vitro antimicrobial drug activity against B. anthracis; 2) in vivo antimicrobial drug efficacy for PEP and treatment; 3) in vivo and human antitoxin efficacy for PEP, treatment, or both; and 4) human survival after antimicrobial drug PEP and treatment of localized anthrax, systemic anthrax, and anthrax meningitis.
B. anthracis strain. In addition, these updated guidelines include new recommendations regarding special considerations for the diagnosis and treatment of anthrax meningitis, including comorbid, social, and clinical predictors of anthrax meningitis. The previously published CDC guidelines and recommendations described potentially beneficial critical care measures and clinical assessment tools and procedures for persons with anthrax, which have not changed and are not addressed in this update. In addition, no changes were made to the Advisory Committee on Immunization Practices recommendations for use of anthrax vaccine (Bower WA, Schiffer J, Atmar RL, et al. Use of anthrax vaccine in the United States: recommendations of the Advisory Committee on Immunization Practices, 2019. MMWR Recomm Rep 2019;68[No. RR-4]:1-14). The updated guidelines in this report can be used by health care providers to prevent and treat anthrax and guide emergency preparedness officials and planners as they develop and update plans for a wide-area aerosol release of B. anthracis.
B. anthracis strain. In addition, these updated guidelines include new recommendations regarding special considerations for the diagnosis and treatment of anthrax meningitis, including comorbid, social, and clinical predictors of anthrax meningitis. The previously published CDC guidelines and recommendations described potentially beneficial critical care measures and clinical assessment tools and procedures for persons with anthrax, which have not changed and are not addressed in this update. In addition, no changes were made to the Advisory Committee on Immunization Practices recommendations for use of anthrax vaccine (Bower WA, Schiffer J, Atmar RL, et al. Use of anthrax vaccine in the United States: recommendations of the Advisory Committee on Immunization Practices, 2019. MMWR Recomm Rep 2019;68[No. RR-4]:1-14). The updated guidelines in this report can be used by health care providers to prevent and treat anthrax and guide emergency preparedness officials and planners as they develop and update plans for a wide-area aerosol release of B. anthracis.
摘要：
■炭疽芽孢杆菌孢子，如果资源有限或使用多药耐药的炭疽芽孢杆菌菌株（HendricksKA，Wright我,阴影SV,etal.炭疽临床指南工作组。疾病控制和预防中心关于预防和治疗成人炭疽的专家小组会议。Emerg感染Dis2014；20：e130687；Meaney-DelmanD，拉斯穆森SA,BeigiRH,etal.孕妇炭疽病的预防和治疗。ObstetGynecol2013；122：885-900；布拉德利JS，孔雀G,KrugSE,etal.小儿炭疽临床管理。儿科2014；133：e1411-36）。具体来说,本报告更新了暴露后预防（PEP）和治疗中抗菌药物和抗毒素的使用，并基于对以下文献的系统评价：1）抗炭疽杆菌的体外抗菌药物活性；2）PEP和治疗的体内抗菌药物功效；3）PEP的体内和人抗毒素功效，治疗,或两者兼而有之；和4）抗微生物药物PEP和局部炭疽治疗后的人类生存，系统性炭疽,和炭疽脑膜炎.
■B炭疽菌株。此外,这些更新的指南包括关于诊断和治疗炭疽脑膜炎的特殊考虑的新建议，包括共病，社会,和炭疽脑膜炎的临床预测因子。先前发布的CDC指南和建议描述了炭疽患者的潜在有益的重症监护措施以及临床评估工具和程序。尚未更改且未在此更新中解决。此外,免疫实践咨询委员会关于使用炭疽疫苗的建议没有变化(BowerWA，SchifferJ,AtmarRL,etal.在美国使用炭疽疫苗：免疫实践咨询委员会的建议，2019.MMWR推荐代表2019；68[编号RR-4]：1-14）。卫生保健提供者可以使用本报告中更新的指南来预防和治疗炭疽，并指导应急准备官员和计划人员制定和更新炭疽杆菌大面积气溶胶释放计划。
■B炭疽菌株。此外,这些更新的指南包括关于诊断和治疗炭疽脑膜炎的特殊考虑的新建议，包括共病，社会,和炭疽脑膜炎的临床预测因子。先前发布的CDC指南和建议描述了炭疽患者的潜在有益的重症监护措施以及临床评估工具和程序。尚未更改且未在此更新中解决。此外,免疫实践咨询委员会关于使用炭疽疫苗的建议没有变化(BowerWA，SchifferJ,AtmarRL,etal.在美国使用炭疽疫苗：免疫实践咨询委员会的建议，2019.MMWR推荐代表2019；68[编号RR-4]：1-14）。卫生保健提供者可以使用本报告中更新的指南来预防和治疗炭疽，并指导应急准备官员和计划人员制定和更新炭疽杆菌大面积气溶胶释放计划。
