Postexposure treatment (prophylaxis) for personnel infected with B. anthracis consists of chemoprophylaxis and vaccination. Oral (i.e. ingested) flouroquinolones are the drugs of choice for adults, including pregnant women. If flouroquinolones are not available, or are contraindicated by medical practitioners, doxycycline is an alternative. Treatment (prophylaxis) should continue until B. anthracis exposure has been excluded.

Postexposure vaccination with an inactivated, cell-free anthrax vaccine is indicated in conjunction with chemoprophylaxis following a proven biologic incident. Postexposure vaccination consists of three injections: as soon as possible after exposure and at 2 and 4 weeks after exposure. Anthrax vaccine can be requested through the CDC or locally supplied agency, however routine vaccination of civilian populations is not recommended as this vaccine has not been evaluated for safety and efficacy in children aged <18 years or adults aged > 60 years. Recommended postexposure prophylaxis for exposure to B. anthracis*

* Prophylaxis should continue until exposure to B. anthracis has been excluded. If exposure is confirmed, prophylaxis should continue for 4 weeks and until 3 doses of vaccine have been administered, or for 8 weeks if vaccine is not available.

** Use of tetracyclines and fluoroquinolones in children has well-known adverse effects; these risks must be weighed carefully against the risk for developing life threatening disease. If a release of B. anthracis is confirmed, children should receive oral amoxicillin 40mg per kg of body mass per day ivided every 8 hours (not to exceed 500mg three times daily) as soon as penicillin susceptibility of the organism has been confirmed.