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2nd Anthrax Drug's Adequacy Questioned; 4 Who Died Received Levaquin First
The Washington Post ^
| November 19, 2001
| Avram Goldstein
Posted on 11/19/2001 12:00:27 PM PST by tgslTakoma
Edited on 09/03/2002 4:49:34 AM PDT by Jim Robinson.
[history]
The four people who died of inhalational anthrax last month were treated primarily with an antibiotic that most doctors have considered equivalent to Cipro, the drug given to the six patients who survived the disease.
Most doctors interviewed last week said it was not statistically meaningful to associate the antibiotic Levaquin with any pattern of unsuccessful anthrax treatment. And they said those who died were thought to have been hospitalized too late for any drug to save them.
(Excerpt) Read more at washingtonpost.com ...
TOPICS: News/Current Events
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It is interesting that all 4 of the people who died from inhalational anthrax were treated with Levaquin, at least initially. It's also difficult for me to believe, after 4 anthrax deaths, that Levaquin is an effective alternative to Cipro (and possibly doxycycline) for treatment of anthrax infection.
At first I thought that maybe Levaquin was a cheaper alternative drug than Cipro, as is doxycycline. I did a little research on web and found that Levaquin is the most expensive of the three drugs (info from Johns Hopkins: Cipro=$7-9/day, Doxycycline=$1/day, Levaquin=$8/day); so now I don't know what to think regarding why doctors chose to treat patients with Levaquin first. I'm not a doc, so can't really offer anything other than speculation... if it's not cost, maybe it's kickbacks to hospitals that led them to stock one drug over another. (I am a big cynic)
To: tgslTakoma
My understanding of the problem is that, with inhalational antrhax, by the time you get sick, it's too late. The antibiotics will kill the anthrax, but the anthrax has already filled you with a fatal dose of its toxin. In other words, it doesn't much matter how effective the antibiotic is.
What is needed to treat inhalational victims is an antitoxin, i.e., a drug that neutralizes the toxin directly, much as an antivenin counteracts snake venom.
2
posted on
11/19/2001 1:59:39 PM PST
by
cynwoody
To: cynwoody
It could be that Levaquin is too good. The anthrax toxins (I believe) are endotoxins, thus released when the anthrax cells die. Kill them all at once and you get a flood, kill them slow and you get a survivable dose.
3
posted on
11/19/2001 3:03:53 PM PST
by
dmcnash
To: aristeides; Alamo-Girl; Nita Nupress
An interesting part of the anthrax story that has gone unnoticed here.
4
posted on
11/21/2001 7:00:05 PM PST
by
kristinn
To: kristinn
Oh, now THIS is interesting. Both Levaquin and Cipro are fluoroquinolones, so I'm not sure if the deaths would be related to the administration of Levaquin in any way. But I'm with the specialist: this needs to be closely examined with animal studies and more research just to make sure. With a cohort size of ten, though, I'm not sure how well you could generalize the results. Thanks for the flag! I'll keep my eyes open and see if I can dig anything up.
To: Nita Nupress
According to the article, Levaquin was not approved for treating inhalation anthrax but Cipro was. Read the entire article and print it out before the link expires. It has some good reporting in it.
6
posted on
11/21/2001 9:02:57 PM PST
by
kristinn
To: kristinn
Ken Alibek in his book Biohazard describes a case of (cutaneous) anthrax (in the Soviet Union) that was so far-gone that it was thought the victim was going to die. He was finally administered massive doses of what Alibek calls "antiserum" -- I assume this is the antitoxin -- and survived. Why isn't that being done for far-gone cases in this country?
To: kristinn
Thanks for the heads up!
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