![]() IV: 400 mg every 12 hours in combination with metronidazole. Note: For acute diverticulitis, some experts suggest deferring antibiotics in otherwise healthy immunocompetent patients with mild disease however, data on this approach in outpatients are limited ( Ref). Other intra-abdominal infections (eg, appendicitis, diverticulitis, intra-abdominal abscess): Note: The addition of anaerobic therapy (eg, metronidazole) is recommended if biliary-enteric anastomosis is present ( Ref).ĭuration: Continue for 1 day after gallbladder removal or until clinical resolution in patients managed nonoperatively ( Ref). Other patients may be switched from IV to oral therapy when clinically improved and able to tolerate an oral diet ( Ref). ![]() ![]() Note: Empiric oral regimens may be appropriate for patients with mild to moderate infection. Intra-abdominal infection, mild to moderate, community-acquired in patients without risk factors for resistance or treatment failure: Following the course of IV combination therapy for systemic anthrax infection (including meningitis), patients exposed to aerosolized spores require oral monotherapy to complete a total antimicrobial course of 60 days ( Ref). Note: Antitoxin should also be administered for systemic anthrax. Systemic (with or without meningitis), treatment (off-label use): IV: 400 mg every 8 hours, in combination with other appropriate agents for ≥2 to 3 weeks or until clinically stable, whichever is longer ( Ref). Note: Treat patients with extensive edema or cutaneous lesions of the head or neck with a parenteral regimen recommended for systemic involvement ( Ref). Note: Anthrax vaccine should also be administered to exposed individuals ( Ref).Ĭutaneous (without systemic involvement), treatment (off-label use): Oral: 500 mg every 12 hours for 7 to 10 days after naturally acquired infection 60 days following biological weapon-related event. Some experts favor longer durations of prophylaxis (eg, total of 3 to 4 months) for patients who are immunocompromised or remain unvaccinated ( Ref). For those who have not previously received an anthrax vaccine, duration ranges from 42 to 60 days ( Ref). ![]() Anthrax: Note: Consult public health officials for event-specific recommendations.ĭuration of therapy: Duration depends on anthrax vaccine status and series completion, age, immune status, and pregnancy/breastfeeding status. He is the editor of Civil War History and author and editor of six other books, including Sick from Freedom: African-American Illness and Suffering during the Civil War and Reconstruction. Jim Downs is Gilder Lehrman-National Endowment for the Humanities Professor of Civil War Era Studies and History at Gettysburg College. Boldly argued and eye-opening, Maladies of Empire gives a full account of the true price of medical progress. The scientific knowledge derived from discarding and exploiting human life is now the basis of our ability to protect humanity from epidemics. The field hospitals of the Crimean War and the US Civil War were carefully observed experiments in disease transmission. Statisticians charted cholera outbreaks by surveilling Muslims in British-dominated territories returning from their annual pilgrimage. Military doctors learned about the importance of air quality by monitoring Africans confined to the bottom of slave ships. ![]() Plantations, slave ships, and battlefields were the laboratories in which physicians came to understand the spread of disease. Reexamining the foundations of modern medicine, Jim Downs shows that the study of infectious disease depended crucially on the unrecognized contributions of nonconsenting subjects-conscripted soldiers, enslaved people, and subjects of empire. Yet histories of individual innovators ignore many key sources of medical knowledge, especially when it comes to the science of infectious disease. Florence Nightingale's contributions to the care of soldiers in the Crimean War revolutionized medical hygiene, transforming hospitals from crucibles of infection to sanctuaries of recuperation. John Snow traced the origins of London's 1854 cholera outbreak to a water pump, leading to the birth of epidemiology. Most stories of medical progress come with ready-made heroes. A sweeping global history that looks beyond European urban centers to show how slavery, colonialism, and war propelled the development of modern medicine. ![]()
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