Johns Hopkins ABX Guide
Anthrax
PATHOGENS
- Bacillus anthracis (Category A bioterrorism agent)
- Spore is a primary infectious form.
- Gram-positive, large rod-shaped organism [Fig 1]
- Virulence factors:
- Antiphagocytic capsule
- Exotoxins: why anti-toxin therapies have been developed given the prominence of these toxins in causing illness.
- Edema toxin (ET)
- Lethal toxin (LT)
- Protective antigen (PA) combines ET and LT, facilitating entry into cells and assisting in downregulating immune responses.
- B. anthracis antimicrobial resistance
- Many antibiotics appear useful with low MICs.
- High-level resistance may be seen for beta-lactams (both penicillins and cephalosporins), TMP-SMX and tetracycline class agents
- Tetracycline-resistance:
- Omadacycline may maintain susceptibility.
- Many antibiotics appear useful with low MICs.
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Last updated: February 10, 2024
Citation
Auwaerter, Paul G. "Anthrax." Johns Hopkins ABX Guide, The Johns Hopkins University, 2024. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540028/all/Anthrax.
Auwaerter PG. Anthrax. Johns Hopkins ABX Guide. The Johns Hopkins University; 2024. https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540028/all/Anthrax. Accessed November 4, 2025.
Auwaerter, P. G. (2024). Anthrax. In Johns Hopkins ABX Guide. The Johns Hopkins University. https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540028/all/Anthrax
Auwaerter PG. Anthrax [Internet]. In: Johns Hopkins ABX Guide. The Johns Hopkins University; 2024. [cited 2025 November 04]. Available from: https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540028/all/Anthrax.
* Article titles in AMA citation format should be in sentence-case
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