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Saturday, September 28, 2013

Trailers (61): Anthrax in pregnancy

Meaney-Delman, et al.  Prophylaxis and treatment of anthrax in pregnant women

Why should you read about this topic?

Because it is inevitable that anthrax prophylaxis for pregnant women will be necessary somewhere in the US in the future.  Also, the review of antibiotic safety in pregnancy is a good resource.

What were the authors trying to do?

Review the safety and pharmacokinetics of antibiotics typically used for prophylaxis and treatment of anthrax in pregnant women

Who participated and in what setting?

Literature review

What was the study design?

Systematic review of primary reports (N=112) on antimicrobial safety and pharmacokinetics

What were the main outcome measures?

Risks for fetal anomalies and neonatal complications

What were the results?

Absolute risks for anomalies are low with antimicrobials used for anthrax prophylaxis and treatment.  Dosages of beta lactam antimicrobials and fluoroquinones should be adjusted for pregnancy.

What is the most interesting image in the paper?

Table 1

What were the study strengths and weaknesses?

Strengths: comprehensive survey of the English language literature.  Weaknesses: systematic reviews are only as good as the primary reports; duration of prophylaxis typically much longer than antimicrobials used in the primary reports

What does the study contribute for your practice?

Don’t hesitate to use these antimicrobials according to CDC guidelines for anthrax post-exposure prophylaxis and treatment in pregnant women.