Clinical Practice Guidelines Example Implementation Guide - Anthrax Post-Exposure Prophylaxis
1.1.0 - ci-build International flag

Clinical Practice Guidelines Example Implementation Guide - Anthrax Post-Exposure Prophylaxis, published by HL7 International - Clinical Decision Support WG. This guide is not an authorized publication; it is the continuous build for version 1.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/cpg-example-anthrax/ and changes regularly. See the Directory of published versions

PlanDefinition: Third vaccine antimicrobial not pregnant (Experimental)

Official URL: http://hl7.org/fhir/uv/cpg/anthrax/PlanDefinition/third-vaccinedose-antimicrobial-notpregnant-pd Version: 1.1.0
Draft as of 2024-08-23 Computable Name: Anthrax_Post_Exposure_Prophylaxis_Adults
Other Identifiers: Anthrax_Post_Exposure_Prophylaxis_FHIRv102_CQL_v110/OrderSet

Usage:Age Range: 18 to ?, Clinical Venue: Outpatient environment, Clinical Focus: Contact with and (suspected) exposure to anthrax, Clinical Focus: Exposure to Bacillus anthracis (event), Clinical Focus: Asymptomatic (finding)

Provides information for treating patients greater than or equal to 18 years old exposed to anthrax within the past 60 days, who do not have anthrax. It is divided into two parts: \n- Part #1: For patients that may be symptomatic to flag the need to conduct a full diagnostic evaluation to rule out anthrax before proceeding with post-exposure prophylaxis (PEP) \n- Part #2: For patients who are asymptomatic (not displaying signs and symptoms of anthrax), it provides recommended PEP regimen

Provides clinicians with information for quickly assessing individuals exposed to anthrax unrelated to occupational exposure, for example in bioterrorism events, and provides the recommended post-exposure prophylaxis (PEP) regimen for asymptomatic patients. Includes immediate treatment with antimicrobials and vaccine and follow-up administration of subsequent vaccines to complete the recommended 3-dose vaccination series.

Generated Narrative: PlanDefinition third-vaccinedose-antimicrobial-notpregnant-pd

url: PlanDefinition Third vaccine antimicrobial not pregnant

identifier: Anthrax_Post_Exposure_Prophylaxis_FHIRv102_CQL_v110/OrderSet

version: 1.1.0

name: Anthrax_Post_Exposure_Prophylaxis_Adults

title: Third vaccine antimicrobial not pregnant

type: ECA Rule

status: Draft

experimental: true

date: 2024-08-23 15:47:13+0000

publisher: HL7 International - Clinical Decision Support WG

contact: HL7 International - Clinical Decision Support WG: http://www.hl7.org/Special/committees/dss/index.cfm

description:

Provides information for treating patients greater than or equal to 18 years old exposed to anthrax within the past 60 days, who do not have anthrax. It is divided into two parts: \n- Part #1: For patients that may be symptomatic to flag the need to conduct a full diagnostic evaluation to rule out anthrax before proceeding with post-exposure prophylaxis (PEP) \n- Part #2: For patients who are asymptomatic (not displaying signs and symptoms of anthrax), it provides recommended PEP regimen

UseContexts

-CodeValue[x]
*UsageContextType age: Age Range18-?
*UsageContextType venue: Clinical VenueOutpatient environment
*UsageContextType focus: Clinical FocusContact with and (suspected) exposure to anthrax
*UsageContextType focus: Clinical FocusExposure to Bacillus anthracis (event)
*UsageContextType focus: Clinical FocusAsymptomatic (finding)

jurisdiction: World

purpose:

Provides clinicians with information for quickly assessing individuals exposed to anthrax unrelated to occupational exposure, for example in bioterrorism events, and provides the recommended post-exposure prophylaxis (PEP) regimen for asymptomatic patients. Includes immediate treatment with antimicrobials and vaccine and follow-up administration of subsequent vaccines to complete the recommended 3-dose vaccination series.

usage: Intended for use by clinicians caring for individuals ≥18 years of age in an outpatient setting.

approvalDate: 2019-06-07

lastReviewDate: 2019-06-07

effectivePeriod: 2019-06-07 --> (ongoing)

topic: Anthrax, Emergency Medicine, Post-Exposure Prophylaxis

author: Alliance to Modernize Healthcare FFRDC:

endorser: Centers for Disease Control and Prevention:

library: Anthrax Post Exposure Prophylaxis (PEP) for Adults FHIRv400 Logic

action

title: Anthrax Post Exposure Prophylaxis 11

trigger

trigger

condition

kind: Applicability

Expressions

-LanguageExpression
*CQLGenerateOrderSet

groupingBehavior: Logical Group

selectionBehavior: Any

action

action


Generated Narrative: ActivityDefinition #CiprofloxacinRequest

url: ActivityDefinition Ciprofloxacin Request

identifier: Anthrax_Post_Exposure_Prophylaxis_FHIRv102_CQL_v110/CiprofloxacinRequest

name: Anthrax_Post_Exposure_Prophylaxis_Adults_Ciprofloxacin_Request

title: Ciprofloxacin Request

status: Draft

experimental: true

description:

In 2009, the US Advisory Committee on Immunization Practices recommended in addition to antimicrobial therapy, a 3-dose series of Anthrax Vaccine Adsorbed (AVA) BioThrax (Emergent BioSolutions Inc., Rockville, MD, USA) for long-term protection after exposure to anthrax in individuals without any previous vaccine. After exposure to aerosolized B. anthracis spores, antimicrobial therapy should be initiated as soon as possible. Ideally, the first dose of vaccine should be administered within 10 days. ACIP recommends a post exposure regimen of 60 days of appropriate antimicrobial prophylaxis (covered previously) combined with 3 subcutaneous doses of AVA (administered at 0, 2, and 4 weeks post exposure) as the most effective protection against inhalation anthrax for previously unvaccinated persons aged ≥18 years who have been exposed to aerosolized B. anthracis spores. In general, the peak serologic response to anthrax vaccine occurs 10–14 days after the third dose. (Wright, J.G et al., Morbidity and Mortality Weekly Report, July 23, 2010 / 59(RR06); 1-30). Additionally, the Advisory Committee on Immunization Practices subsequently reviewed all safety data available as of March 2008, including the final results of a retrospective study, and concluded that AVA is safe to administer to anthrax-exposed women during pregnancy. In the setting of an anthrax event that poses a high risk for exposure to aerosolized B. anthracis spores, pregnancy is neither a precaution nor a contraindication to vaccination. Pregnant women at risk for inhalation anthrax should receive AVA and antimicrobial drug therapy regardless of pregnancy trimester (Meanye-Delman D et al., Emerg Infect Dis, 20(2), 2014).

UseContexts

-CodeValue[x]
*UsageContextType age: Age Range18-?
*UsageContextType venue: Clinical VenueOutpatient environment
*UsageContextType focus: Clinical FocusContact with and (suspected) exposure to anthrax
*UsageContextType focus: Clinical FocusExposure to Bacillus anthracis (event)
*UsageContextType focus: Clinical FocusAsymptomatic (finding)

purpose:

Provides clinicians with information for quickly assessing individuals exposed to anthrax unrelated to occupational exposure, for example in bioterrorism events, and provides the recommended post-exposure prophylaxis (PEP) regimen for asymptomatic patients. Includes immediate treatment with antimicrobials and vaccine and follow-up administration of subsequent vaccines to complete the recommended 3-dose vaccination series.

usage: Intended for use by clinicians caring for individuals ≥18 years of age in an outpatient setting.

approvalDate: 2019-06-07

lastReviewDate: 2019-06-07

effectivePeriod: 2019-06-07 --> (ongoing)

topic: Anthrax, Emergency Medicine, Post-Exposure Prophylaxis

author: Alliance to Modernize Healthcare FFRDC:

endorser: Centers for Disease Control and Prevention:

kind: MedicationRequest

product: Ciprofloxacin 500 MG Oral Tablet

quantity: 120(unit ORTAB from http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm) (Details: Orderable Drug Form codeORTAB = 'Oral Tablet')

Dosages

-TextAdditionalInstructionPatientInstructionTimingRouteMethod
*One every 12 hours for 60 daysCONTRAINDICATIONS: Diagnosis of myasthenia gravis and taking tizanidine., CAUTIONS: If patient is taking blood thinners, oral antidiabetic drugs, seizure drugs, theophylline, drugs that prolong QT interval, duloxetine (Cymbalta), zolpidem (Ambien), clozapine or any other drug that may interact and cause serious side effects, consider another antibiotic regimen., Provide patient education on medications.Take with full glass of waterOnce per12 hoursOral RouteSwallow - dosing instruction imperative (qualifier value)

Generated Narrative: ActivityDefinition #DoxycyclineRequest

url: ActivityDefinition Doxycycline Request

identifier: Anthrax_Post_Exposure_Prophylaxis_FHIRv102_CQL_v110/DoxycyclineRequest

name: Anthrax_Post_Exposure_Prophylaxis_Adults_Doxycycline_Request

title: Doxycycline Request

status: Draft

experimental: true

description:

In 2009, the US Advisory Committee on Immunization Practices recommended in addition to antimicrobial therapy, a 3-dose series of Anthrax Vaccine Adsorbed (AVA) BioThrax (Emergent BioSolutions Inc., Rockville, MD, USA) for long-term protection after exposure to anthrax in individuals without any previous vaccine. After exposure to aerosolized B. anthracis spores, antimicrobial therapy should be initiated as soon as possible. Ideally, the first dose of vaccine should be administered within 10 days. ACIP recommends a post exposure regimen of 60 days of appropriate antimicrobial prophylaxis (covered previously) combined with 3 subcutaneous doses of AVA (administered at 0, 2, and 4 weeks post exposure) as the most effective protection against inhalation anthrax for previously unvaccinated persons aged ≥18 years who have been exposed to aerosolized B. anthracis spores. In general, the peak serologic response to anthrax vaccine occurs 10–14 days after the third dose. (Wright, J.G et al., Morbidity and Mortality Weekly Report, July 23, 2010 / 59(RR06); 1-30). Additionally, the Advisory Committee on Immunization Practices subsequently reviewed all safety data available as of March 2008, including the final results of a retrospective study, and concluded that AVA is safe to administer to anthrax-exposed women during pregnancy. In the setting of an anthrax event that poses a high risk for exposure to aerosolized B. anthracis spores, pregnancy is neither a precaution nor a contraindication to vaccination. Pregnant women at risk for inhalation anthrax should receive AVA and antimicrobial drug therapy regardless of pregnancy trimester (Meanye-Delman D et al., Emerg Infect Dis, 20(2), 2014).

UseContexts

-CodeValue[x]
*UsageContextType age: Age Range18-?
*UsageContextType venue: Clinical VenueOutpatient environment
*UsageContextType focus: Clinical FocusContact with and (suspected) exposure to anthrax
*UsageContextType focus: Clinical FocusExposure to Bacillus anthracis (event)
*UsageContextType focus: Clinical FocusAsymptomatic (finding)

purpose:

Provides clinicians with information for quickly assessing individuals exposed to anthrax unrelated to occupational exposure, for example in bioterrorism events, and provides the recommended post-exposure prophylaxis (PEP) regimen for asymptomatic patients. Includes immediate treatment with antimicrobials and vaccine and follow-up administration of subsequent vaccines to complete the recommended 3-dose vaccination series.

usage: Intended for use by clinicians caring for individuals ≥18 years of age in an outpatient setting.

approvalDate: 2019-06-07

lastReviewDate: 2019-06-07

effectivePeriod: 2019-06-07 --> (ongoing)

topic: Anthrax, Emergency Medicine, Post-Exposure Prophylaxis

author: Alliance to Modernize Healthcare FFRDC:

endorser: Centers for Disease Control and Prevention:

kind: MedicationRequest

product: doxycycline hyclate 100 MG Oral Tablet

quantity: 120(unit ORTAB from http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm) (Details: Orderable Drug Form codeORTAB = 'Oral Tablet')

Dosages

-TextAdditionalInstructionPatientInstructionTimingRouteMethod
*One every 12 hours for 60 daysCAUTIONS: If patient is taking blood thinners, oral antidiabetic drugs, seizure drugs, or any other drug that may interact and cause serious side effects, consider another antibiotic regimen., Provide patient education on medications.Take with full glass of waterOnce per12 hoursOral RouteSwallow - dosing instruction imperative (qualifier value)

Generated Narrative: ActivityDefinition #LevofloxacinRequest

url: ActivityDefinition Levofloxacin Request

identifier: Anthrax_Post_Exposure_Prophylaxis_FHIRv102_CQL_v110/LevofloxacinRequest

name: Anthrax_Post_Exposure_Prophylaxis_Adults_Levofloxacin_Request

title: Levofloxacin Request

status: Draft

experimental: true

description:

In 2009, the US Advisory Committee on Immunization Practices recommended in addition to antimicrobial therapy, a 3-dose series of Anthrax Vaccine Adsorbed (AVA) BioThrax (Emergent BioSolutions Inc., Rockville, MD, USA) for long-term protection after exposure to anthrax in individuals without any previous vaccine. After exposure to aerosolized B. anthracis spores, antimicrobial therapy should be initiated as soon as possible. Ideally, the first dose of vaccine should be administered within 10 days. ACIP recommends a post exposure regimen of 60 days of appropriate antimicrobial prophylaxis (covered previously) combined with 3 subcutaneous doses of AVA (administered at 0, 2, and 4 weeks post exposure) as the most effective protection against inhalation anthrax for previously unvaccinated persons aged ≥18 years who have been exposed to aerosolized B. anthracis spores. In general, the peak serologic response to anthrax vaccine occurs 10–14 days after the third dose. (Wright, J.G et al., Morbidity and Mortality Weekly Report, July 23, 2010 / 59(RR06); 1-30). Additionally, the Advisory Committee on Immunization Practices subsequently reviewed all safety data available as of March 2008, including the final results of a retrospective study, and concluded that AVA is safe to administer to anthrax-exposed women during pregnancy. In the setting of an anthrax event that poses a high risk for exposure to aerosolized B. anthracis spores, pregnancy is neither a precaution nor a contraindication to vaccination. Pregnant women at risk for inhalation anthrax should receive AVA and antimicrobial drug therapy regardless of pregnancy trimester (Meanye-Delman D et al., Emerg Infect Dis, 20(2), 2014).

UseContexts

-CodeValue[x]
*UsageContextType age: Age Range18-?
*UsageContextType venue: Clinical VenueOutpatient environment
*UsageContextType focus: Clinical FocusContact with and (suspected) exposure to anthrax
*UsageContextType focus: Clinical FocusExposure to Bacillus anthracis (event)
*UsageContextType focus: Clinical FocusAsymptomatic (finding)

purpose:

Provides clinicians with information for quickly assessing individuals exposed to anthrax unrelated to occupational exposure, for example in bioterrorism events, and provides the recommended post-exposure prophylaxis (PEP) regimen for asymptomatic patients. Includes immediate treatment with antimicrobials and vaccine and follow-up administration of subsequent vaccines to complete the recommended 3-dose vaccination series.

usage: Intended for use by clinicians caring for individuals ≥18 years of age in an outpatient setting.

approvalDate: 2019-06-07

lastReviewDate: 2019-06-07

effectivePeriod: 2019-06-07 --> (ongoing)

topic: Anthrax, Emergency Medicine, Post-Exposure Prophylaxis

author: Alliance to Modernize Healthcare FFRDC:

endorser: Centers for Disease Control and Prevention:

kind: MedicationRequest

product: Levofloxacin 750 MG Oral Tablet

quantity: 60(unit ORTAB from http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm) (Details: Orderable Drug Form codeORTAB = 'Oral Tablet')

Dosages

-TextAdditionalInstructionTimingRouteMethod
*One every day for 60 daysnoneOnce per1 daysOral RouteSwallow - dosing instruction imperative (qualifier value)

Generated Narrative: ActivityDefinition #MoxifloxacinRequest

url: ActivityDefinition Moxifloxacin Request

identifier: Anthrax_Post_Exposure_Prophylaxis_FHIRv102_CQL_v110/MoxifloxacinRequest

name: Anthrax_Post_Exposure_Prophylaxis_Adults_Moxifloxacin_Request

title: Moxifloxacin Request

status: Draft

experimental: true

description:

In 2009, the US Advisory Committee on Immunization Practices recommended in addition to antimicrobial therapy, a 3-dose series of Anthrax Vaccine Adsorbed (AVA) BioThrax (Emergent BioSolutions Inc., Rockville, MD, USA) for long-term protection after exposure to anthrax in individuals without any previous vaccine. After exposure to aerosolized B. anthracis spores, antimicrobial therapy should be initiated as soon as possible. Ideally, the first dose of vaccine should be administered within 10 days. ACIP recommends a post exposure regimen of 60 days of appropriate antimicrobial prophylaxis (covered previously) combined with 3 subcutaneous doses of AVA (administered at 0, 2, and 4 weeks post exposure) as the most effective protection against inhalation anthrax for previously unvaccinated persons aged ≥18 years who have been exposed to aerosolized B. anthracis spores. In general, the peak serologic response to anthrax vaccine occurs 10–14 days after the third dose. (Wright, J.G et al., Morbidity and Mortality Weekly Report, July 23, 2010 / 59(RR06); 1-30). Additionally, the Advisory Committee on Immunization Practices subsequently reviewed all safety data available as of March 2008, including the final results of a retrospective study, and concluded that AVA is safe to administer to anthrax-exposed women during pregnancy. In the setting of an anthrax event that poses a high risk for exposure to aerosolized B. anthracis spores, pregnancy is neither a precaution nor a contraindication to vaccination. Pregnant women at risk for inhalation anthrax should receive AVA and antimicrobial drug therapy regardless of pregnancy trimester (Meanye-Delman D et al., Emerg Infect Dis, 20(2), 2014).

UseContexts

-CodeValue[x]
*UsageContextType age: Age Range18-?
*UsageContextType venue: Clinical VenueOutpatient environment
*UsageContextType focus: Clinical FocusContact with and (suspected) exposure to anthrax
*UsageContextType focus: Clinical FocusExposure to Bacillus anthracis (event)
*UsageContextType focus: Clinical FocusAsymptomatic (finding)

purpose:

Provides clinicians with information for quickly assessing individuals exposed to anthrax unrelated to occupational exposure, for example in bioterrorism events, and provides the recommended post-exposure prophylaxis (PEP) regimen for asymptomatic patients. Includes immediate treatment with antimicrobials and vaccine and follow-up administration of subsequent vaccines to complete the recommended 3-dose vaccination series.

usage: Intended for use by clinicians caring for individuals ≥18 years of age in an outpatient setting.

approvalDate: 2019-06-07

lastReviewDate: 2019-06-07

effectivePeriod: 2019-06-07 --> (ongoing)

topic: Anthrax, Emergency Medicine, Post-Exposure Prophylaxis

author: Alliance to Modernize Healthcare FFRDC:

endorser: Centers for Disease Control and Prevention:

kind: MedicationRequest

product: moxifloxacin HCl 400 MG Oral Tablet

quantity: 60(unit ORTAB from http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm) (Details: Orderable Drug Form codeORTAB = 'Oral Tablet')

Dosages

-TextAdditionalInstructionTimingRouteMethod
*One every day for 60 daysnoneOnce per1 daysOral RouteSwallow - dosing instruction imperative (qualifier value)

Generated Narrative: ActivityDefinition #ClindamycinRequest

url: ActivityDefinition Clindamycin Request

identifier: Anthrax_Post_Exposure_Prophylaxis_FHIRv102_CQL_v110/ClindamycinRequest

name: Anthrax_Post_Exposure_Prophylaxis_Adults_Clindamycin_Request

title: Clindamycin Request

status: Draft

experimental: true

description:

In 2009, the US Advisory Committee on Immunization Practices recommended in addition to antimicrobial therapy, a 3-dose series of Anthrax Vaccine Adsorbed (AVA) BioThrax (Emergent BioSolutions Inc., Rockville, MD, USA) for long-term protection after exposure to anthrax in individuals without any previous vaccine. After exposure to aerosolized B. anthracis spores, antimicrobial therapy should be initiated as soon as possible. Ideally, the first dose of vaccine should be administered within 10 days. ACIP recommends a post exposure regimen of 60 days of appropriate antimicrobial prophylaxis (covered previously) combined with 3 subcutaneous doses of AVA (administered at 0, 2, and 4 weeks post exposure) as the most effective protection against inhalation anthrax for previously unvaccinated persons aged ≥18 years who have been exposed to aerosolized B. anthracis spores. In general, the peak serologic response to anthrax vaccine occurs 10–14 days after the third dose. (Wright, J.G et al., Morbidity and Mortality Weekly Report, July 23, 2010 / 59(RR06); 1-30). Additionally, the Advisory Committee on Immunization Practices subsequently reviewed all safety data available as of March 2008, including the final results of a retrospective study, and concluded that AVA is safe to administer to anthrax-exposed women during pregnancy. In the setting of an anthrax event that poses a high risk for exposure to aerosolized B. anthracis spores, pregnancy is neither a precaution nor a contraindication to vaccination. Pregnant women at risk for inhalation anthrax should receive AVA and antimicrobial drug therapy regardless of pregnancy trimester (Meanye-Delman D et al., Emerg Infect Dis, 20(2), 2014).

UseContexts

-CodeValue[x]
*UsageContextType age: Age Range18-?
*UsageContextType venue: Clinical VenueOutpatient environment
*UsageContextType focus: Clinical FocusContact with and (suspected) exposure to anthrax
*UsageContextType focus: Clinical FocusExposure to Bacillus anthracis (event)
*UsageContextType focus: Clinical FocusAsymptomatic (finding)

purpose:

Provides clinicians with information for quickly assessing individuals exposed to anthrax unrelated to occupational exposure, for example in bioterrorism events, and provides the recommended post-exposure prophylaxis (PEP) regimen for asymptomatic patients. Includes immediate treatment with antimicrobials and vaccine and follow-up administration of subsequent vaccines to complete the recommended 3-dose vaccination series.

usage: Intended for use by clinicians caring for individuals ≥18 years of age in an outpatient setting.

approvalDate: 2019-06-07

lastReviewDate: 2019-06-07

effectivePeriod: 2019-06-07 --> (ongoing)

topic: Anthrax, Emergency Medicine, Post-Exposure Prophylaxis

author: Alliance to Modernize Healthcare FFRDC:

endorser: Centers for Disease Control and Prevention:

kind: MedicationRequest

product: clindamycin HCl 300 MG Oral Capsule

quantity: 360(unit ORTAB from http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm) (Details: Orderable Drug Form codeORTAB = 'Oral Tablet')

Dosages

-TextAdditionalInstructionTimingRouteMethod
*Two tablets every 8 hours for 60 daysnone2 per8 hoursOral RouteSwallow - dosing instruction imperative (qualifier value)

Generated Narrative: ActivityDefinition #Inline-Vaccine-Request-10

url: http://hl7.org/fhir/uv/cpg/anthrax/ActivityDefinition/Inline-Vaccine-Request-10

identifier: Anthrax_Post_Exposure_Prophylaxis_FHIRv102_CQL_v110/VaccineRequest

name: Anthrax_Post_Exposure_Prophylaxis_Adults_Vaccine_Request

title: Anthrax Post Exposure Prophylaxis (PEP) for Adults: Vaccine Request

status: Draft

experimental: true

description:

In 2009, the US Advisory Committee on Immunization Practices recommended in addition to antimicrobial therapy, a 3-dose series of Anthrax Vaccine Adsorbed (AVA) BioThrax (Emergent BioSolutions Inc., Rockville, MD, USA) for long-term protection after exposure to anthrax in individuals without any previous vaccine. After exposure to aerosolized B. anthracis spores, antimicrobial therapy should be initiated as soon as possible. Ideally, the first dose of vaccine should be administered within 10 days. ACIP recommends a post exposure regimen of 60 days of appropriate antimicrobial prophylaxis (covered previously) combined with 3 subcutaneous doses of AVA (administered at 0, 2, and 4 weeks post exposure) as the most effective protection against inhalation anthrax for previously unvaccinated persons aged ≥18 years who have been exposed to aerosolized B. anthracis spores. In general, the peak serologic response to anthrax vaccine occurs 10–14 days after the third dose. (Wright, J.G et al., Morbidity and Mortality Weekly Report, July 23, 2010 / 59(RR06); 1-30). Additionally, the Advisory Committee on Immunization Practices subsequently reviewed all safety data available as of March 2008, including the final results of a retrospective study, and concluded that AVA is safe to administer to anthrax-exposed women during pregnancy. In the setting of an anthrax event that poses a high risk for exposure to aerosolized B. anthracis spores, pregnancy is neither a precaution nor a contraindication to vaccination. Pregnant women at risk for inhalation anthrax should receive AVA and antimicrobial drug therapy regardless of pregnancy trimester (Meanye-Delman D et al., Emerg Infect Dis, 20(2), 2014).

UseContexts

-CodeValue[x]
*UsageContextType age: Age Range18-?
*UsageContextType venue: Clinical VenueOutpatient environment
*UsageContextType focus: Clinical FocusContact with and (suspected) exposure to anthrax
*UsageContextType focus: Clinical FocusExposure to Bacillus anthracis (event)
*UsageContextType focus: Clinical FocusAsymptomatic (finding)

purpose:

Provides clinicians with information for quickly assessing individuals exposed to anthrax unrelated to occupational exposure, for example in bioterrorism events, and provides the recommended post-exposure prophylaxis (PEP) regimen for asymptomatic patients. Includes immediate treatment with antimicrobials and vaccine and follow-up administration of subsequent vaccines to complete the recommended 3-dose vaccination series.

usage: Intended for use by clinicians caring for individuals ≥18 years of age in an outpatient setting.

approvalDate: 2019-06-07

lastReviewDate: 2019-06-07

effectivePeriod: 2019-06-07 --> (ongoing)

topic: Anthrax, Emergency Medicine, Post-Exposure Prophylaxis

author: Alliance to Modernize Healthcare FFRDC:

endorser: Centers for Disease Control and Prevention:

kind: ImmunizationRecommendation

code: Anthrax vaccination

product: Anthrax vaccine

dosage