Commentary on Non-Labeled Dosing of Oral Amoxicillin in Adults and Pediatrics for Post-Exposure Inhalational Anthrax

Recommendations from the Centers for Disease Control and Prevention (CDC)1 and the Johns Hopkins Working Group on Civilian Biodefense have included amoxicillin, among other drugs, for post-exposure prophylaxis (i.e., prevention) of inhalational anthrax following exposure to Bacillus anthracis.2Although there are other approved antibacterial products, amoxicillin is also considered as a therapeutic option in those patients for whom approved products may be contraindicated and when the B. anthracis strain is susceptible to penicillin.The Food and Drug Administration (FDA) recommends dosing for amoxicillin in adult and pediatric patients for penicillin-susceptible strains of B. anthracis, based on the principles discussed below, provided in the following table. Population Dose Every 8 hours Adults and Pediatric Patients ≥ 40 kg 1000 mg Pediatric Patients < 40=""> 25 mg/kg Background Amoxicillin Pharmacokinetics in Adult Patients Amoxicillin Pharmacokinetics in Pediatric Patients Reference...