Recommended postexposure prophylaxis for exposure to Bacillus anthracis* by  CDC
12-Oct. 2001

Oral fluroquinolones
One of the following:
Ciprofloxacin 500 mg twice daily
children :20–30 mg per kg of body mass per day divided every 12 hours
Levofloxacin 500 mg once daily
children not recomended
Ofloxacin 400 mg twice daily
children not recomended

If fluoroquinolones are not available or are contraindicated

Doxycycline 100 mg twice daily 
children :5 mg per kg of body mass per day divided every 12 hours

Prophylaxis should continue until exposure to B. anthracis has been excluded. 
If exposure is confirmed, prophylaxis should continue for 4 weeks and until three doses of vaccine have been administered or for 8 weeks if vaccine is not available.

Use of tetracyclines and fluoroquinolones in children has well-known adverse effects; these risks must be weighed carefully against the risk for developing life-threatening disease. If a release of B. anthracis is confirmed, children should receive oral amoxicillin 40 mg per kg of body mass per day divided every 8 hours (not to exceed 500 mg three times daily) as soon as penicillin susceptibility of the organism has been confirmed.

1. Postexposure vaccination with an inactivated, cellfree anthrax vaccine (Bioport Corporation, formerly Michigan Biologic Products Institute † ) is indicated in conjunction with chemoprophylaxis following a proven biologic incident (T.V. Inglesby, D.A. Henderson, J.G. Bartlett, et al., Working Group for Civilian Biodefense, personal com-munication, 1998; 4 ).
2. Postexposure vaccination consists of three injections: as soon as possible after exposure and at 2 and 4 weeks after exposure. Anthrax vaccine can be requested through CDC. Although this vaccine is now being administered routinely to U.S. military personnel, routine vaccination of civilian populations is not recommended.
3. This vaccine has not been evaluated for safety and efficacy in children aged  <18 years or adults aged >60 years.
4. If decontamination is appropriate, persons should remove their clothing and personal effects, place all items in plastic bags, and shower using copious quantities of soap and water . Plastic bags with personal effects should be labeled clearly with the owner’s name, contact telephone number, and inventory of the bag’s contents.
5. For incidents involving possibly contaminated letters, the environment in direct contact with the letter or its contents should be decontaminated with a 0.5% hypochlorite solution (i.e., one part household bleach to 10 parts water) following a crime scene investigation.
   Personal effects may be decontaminated similarly.