Evidence map›Paper›PMID 32697310›Full record

ArticleThe Journal of infectious diseases2021

Clindamycin Protects Nonhuman Primates Against Inhalational Anthrax But Does Not Enhance Reduction of Circulating Toxin Levels When Combined With Ciprofloxacin.

Nicholas J Vietri, Steven A Tobery, Donald J Chabot, Susham Ingavale, Brandon C Somerville, Jeremy A Miller, Chris W Schellhase, Nancy A Twenhafel, David P Fetterer, Christopher K Cote and 6 more

Open access · bronzeAbstract read
In one paragraph

Article in The Journal of infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Postexposure Prophylaxis and Treatment of Bacillus anthracis Infections: A Systematic Review and Meta-analyses of Animal Models, 1947-2019.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022
    Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 5 institutions in 1 country.

Nicholas J VietriDivision of Bacteriology, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA.
Steven A ToberyDivision of Bacteriology, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA.
Donald J ChabotDivision of Bacteriology, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA.
Susham IngavaleDivision of Bacteriology, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA.
Brandon C SomervilleDivision of Bacteriology, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA.
Jeremy A MillerDivision of Bacteriology, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA.
Chris W SchellhaseDivision of Pathology, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA.
Nancy A TwenhafelDivision of Pathology, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA.
David P FettererDivision of Biostatistics, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA.
Christopher K CoteDivision of Bacteriology, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA.
Christopher P KlimkoDivision of Bacteriology, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA.
Anne E BoyerNational Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Adrian R WoolfittNational Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
John R BarrNational Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Mary E WrightDivision of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA.
Arthur M FriedlanderHeadquarters, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA.
United States Army Medical Research Institute of Infectious Diseases · USCenters for Disease Control and Prevention · USNational Center for Environmental Health · USNational Institute of Allergy and Infectious Diseases · USUniformed Services University of the Health Sciences · US

Funding

Intramural CDC HHS CC999999
6 · The paper itself

Abstract

backgroundInhalational anthrax is rare and clinical experience limited. Expert guidelines recommend treatment with combination antibiotics including protein synthesis-inhibitors to decrease toxin production and increase survival, although evidence is lacking.

methodsRhesus macaques exposed to an aerosol of Bacillus anthracis spores were treated with ciprofloxacin, clindamycin, or ciprofloxacin + clindamycin after becoming bacteremic. Circulating anthrax lethal factor and protective antigen were quantitated pretreatment and 1.5 and 12 hours after beginning antibiotics.

resultsIn the clindamycin group, 8 of 11 (73%) survived demonstrating its efficacy for the first time in inhalational anthrax, compared to 9 of 9 (100%) with ciprofloxacin, and 8 of 11 (73%) with ciprofloxacin + clindamycin. These differences were not statistically significant. There were no significant differences between groups in lethal factor or protective antigen levels from pretreatment to 12 hours after starting antibiotics. Animals that died after clindamycin had a greater incidence of meningitis compared to those given ciprofloxacin or ciprofloxacin + clindamycin, but numbers of animals were very low and no definitive conclusion could be reached.

conclusionTreatment of inhalational anthrax with clindamycin was as effective as ciprofloxacin in the nonhuman primate. Addition of clindamycin to ciprofloxacin did not enhance reduction of circulating toxin levels.

Indexed as

AnimalsAnthraxAnti-Bacterial AgentsAntigens, BacterialBacillus anthracisBacterial ToxinsBiomarkersCiprofloxacinClindamycinDisease Models, AnimalDrug Therapy, CombinationMacaca mulattaPrognosisRespiratory Tract InfectionsTreatment Outcomeanthrax toxinAnti-Bacterial AgentsAntigens, BacterialBacterial ToxinsBiomarkersCiprofloxacinClindamycinanthraxantibioticsciprofloxacinclindamycinlethal factorprotective antigentoxinstreatment

Identifiers

PMID32697310
PMCPMC7857151
OpenAlexW3045139000

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.