1. Postexposure Prophylaxis After Possible Anthrax Exposure: Adherence and Adverse Events.
- Author
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Nolen LD, Traxler RM, Kharod GA, Kache PA, Katharios-Lanwermeyer S, Hendricks KA, Shadomy SV, Bower WA, Meaney-Delman D, and Walke HT
- Subjects
- Adult, Anti-Bacterial Agents adverse effects, Bacillus anthracis, Centers for Disease Control and Prevention, U.S., Ciprofloxacin administration & dosage, Ciprofloxacin adverse effects, Doxycycline administration & dosage, Doxycycline adverse effects, Female, Georgia, Humans, Male, Occupational Exposure prevention & control, United States, Anthrax prevention & control, Anti-Bacterial Agents administration & dosage, Medication Adherence psychology, Post-Exposure Prophylaxis, Vaccination Refusal psychology
- Abstract
Anthrax postexposure prophylaxis (PEP) was recommended to 42 people after a laboratory incident that involved potential aerosolization of Bacillus anthracis spores in 2 laboratories at the Centers for Disease Control and Prevention in 2014. At least 31 (74%) individuals who initiated PEP did not complete either the recommended 60 days of antimicrobial therapy or the 3-dose vaccine regimen. Among the 29 that discontinued the antimicrobial component of PEP, most (38%) individuals discontinued PEP because of their low perceived risk of infection; 9 (31%) individuals discontinued prophylaxis due to PEP-related minor adverse events, and 10% cited both low risk and adverse events as their reason for discontinuation. Most minor adverse events reported were gastrointestinal complaints, and none required medical attention. Individuals taking ciprofloxacin were twice as likely (RR = 2.02, 95% CI = 1.1-3.6) to discontinue antimicrobial prophylaxis when compared to those taking doxycycline. In the event anthrax PEP is recommended, public health messages and patient education materials will need to address potential misconceptions regarding exposure risk and provide information about possible adverse events in order to promote PEP adherence.
- Published
- 2016
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