Evidence map›Paper›PMID 36251546›Full record

SynthesisClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022

Postexposure Prophylaxis and Treatment of Bacillus anthracis Infections: A Systematic Review and Meta-analyses of Animal Models, 1947-2019.

Jordan L Kennedy, Jürgen B Bulitta, Kevin Chatham-Stephens, Marissa K Person, Rachel Cook, Thitipong Mongkolrattanothai, Eunjeong Shin, Patricia Yu, Maria E Negron, William A Bower and 1 more

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 38% 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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Systematic Review of Hospital Treatment Outcomes for Naturally Acquired and Bioterrorism-Related Anthrax, 1880-2018.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022
    Pooled it
  2. Central Nervous System Antimicrobial Exposure and Proposed Dosing for Anthrax Meningitis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024
    Article
  3. Article
  4. CDC Guidelines for the Prevention and Treatment of Anthrax, 2023.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2023
    Article
  5. Responding to the Threat Posed by Anthrax: Updated Evidence to Improve Preparedness.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022
    Article
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

11 authors at 2 institutions in 1 country.

Jordan L KennedyDivision of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Jürgen B BulittaDepartment of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Orlando, Florida, USA.
Kevin Chatham-StephensDivision of Human Development and Disability, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Marissa K PersonDivision of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Rachel CookOak Ridge Institute for Science and Education, CDC Fellowship Program, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Thitipong MongkolrattanothaiOak Ridge Institute for Science and Education, CDC Fellowship Program, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Eunjeong ShinDepartment of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Orlando, Florida, USA.
Patricia YuDivision of Preparedness and Emerging Infections, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Maria E NegronDivision of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
William A BowerDivision of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.ORCID 0000-0001-6538-8665
Katherine HendricksDivision of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Centers for Disease Control and Prevention · USUniversity of Florida · US

Funding

CDC HHS
6 · The paper itself

Abstract

backgroundAnthrax is endemic to many countries, including the United States. The causative agent, Bacillus anthracis, poses a global bioterrorism threat. Without effective antimicrobial postexposure prophylaxis (PEPAbx) and treatment, the mortality of systemic anthrax is high. To inform clinical guidelines for PEPAbx and treatment of B. anthracis infections in humans, we systematically evaluated animal anthrax treatment model studies.

methodsWe searched for survival outcome data in 9 scientific search engines for articles describing antimicrobial PEPAbx or treatment of anthrax in animals in any language through February 2019. We performed meta-analyses of efficacy of antimicrobial PEPAbx and treatment for each drug or drug combination using random-effects models. Pharmacokinetic/pharmacodynamic relationships were developed for 5 antimicrobials with available pharmacokinetic data. Monte Carlo simulations were used to predict unbound drug exposures in humans.

resultsWe synthesized data from 34 peer-reviewed studies with 3262 animals. For PEPAbx and treatment of infection by susceptible B. anthracis, effective monotherapy can be accomplished with fluoroquinolones, tetracyclines, β-lactams (including penicillin, amoxicillin-clavulanate, and imipenem-cilastatin), and lipopeptides or glycopeptides. For naturally occurring strains, unbound drug exposures in humans were predicted to adequately cover the minimal inhibitory concentrations (MICs; those required to inhibit the growth of 50% or 90% of organisms [MIC50 or MIC90]) for ciprofloxacin, levofloxacin, and doxycycline for both the PEPAbx and treatment targets. Dalbavancin covered its MIC50 for PEPAbx.

conclusionsThese animal studies show many reviewed antimicrobials are good choices for PEPAbx or treatment of susceptible B. anthracis strains, and some are also promising options for combating resistant strains. Monte Carlo simulations suggest that oral ciprofloxacin, levofloxacin, and doxycycline are particularly robust choices for PEPAbx or treatment.

Indexed as

AnthraxAnti-Infective AgentsBacillus anthracisAmoxicillin-Potassium Clavulanate CombinationAnimalsAnti-Bacterial Agentsbeta-LactamsCilastatin, Imipenem Drug CombinationCiprofloxacinDoxycyclineGlycopeptidesHumansLevofloxacinLipopeptidesModels, AnimalTetracyclinesAmoxicillin-Potassium Clavulanate CombinationAnti-Bacterial AgentsAnti-Infective Agentsbeta-LactamsCilastatin, Imipenem Drug CombinationCiprofloxacinDoxycyclineGlycopeptidesLevofloxacinLipopeptidesTetracyclinesanthraxantimicrobialdrug-resistantpostexposure prophylaxistreatment

Identifiers

PMID36251546
PMCPMC9649436
OpenAlexW4306632745

What OpenQuestion holds

Textmetadata
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.