Postexposure Prophylaxis After Possible Anthrax Exposure: Adherence and Adverse Events

Area of Science:

• Public Health
• Infectious Diseases
• Occupational Health

Background:

• A 2014 laboratory incident involving Bacillus anthracis spores necessitated postexposure prophylaxis (PEP) for 42 individuals.
• Adherence to the full PEP regimen, including antimicrobials and vaccines, was suboptimal.

Purpose of the Study:

• To evaluate adherence to anthrax postexposure prophylaxis (PEP) following a laboratory incident.
• To identify reasons for PEP discontinuation and compare adherence between antimicrobial agents.

Main Methods:

• Retrospective analysis of PEP completion rates and reasons for discontinuation.
• Comparison of discontinuation rates between ciprofloxacin and doxycycline users.

Main Results:

• Only 26% of individuals completed the recommended PEP regimen.
• Primary reasons for discontinuation included low perceived risk of infection (38%) and minor adverse events (31%).
• Ciprofloxacin users were twice as likely to discontinue PEP compared to doxycycline users.

Conclusions:

• Low adherence to anthrax PEP is a significant concern, driven by perceived low risk and adverse events.
• Targeted patient education addressing risk perception and managing side effects is crucial for improving PEP adherence.
• Antimicrobial choice may influence adherence, suggesting further investigation into patient-reported outcomes.