Emerging Infectious Diseases (Jan 2017)

Analysis of Anthrax Immune Globulin Intravenous with Antimicrobial Treatment in Injection Drug Users, Scotland, 2009–2010

  • Xizhong Cui,
  • Leisha D. Nolen,
  • Junfeng Sun,
  • Malcolm Booth,
  • Lindsay Donaldson,
  • Conrad P. Quinn,
  • Anne E. Boyer,
  • Katherine A. Hendricks,
  • Sean Shadomy,
  • Pieter Bothma,
  • Owen Judd,
  • Paul McConnell,
  • William A. Bower,
  • Peter Q. Eichacker

DOI
https://doi.org/10.3201/eid2301.160608
Journal volume & issue
Vol. 23, no. 1
pp. 56 – 65

Abstract

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We studied anthrax immune globulin intravenous (AIG-IV) use from a 2009–2010 outbreak of Bacillus anthracis soft tissue infection in injection drug users in Scotland, UK, and we compared findings from 15 AIG-IV recipients with findings from 28 nonrecipients. Death rates did not differ significantly between recipients and nonrecipients (33% vs. 21%). However, whereas only 8 (27%) of 30 patients at low risk for death (admission sequential organ failure assessment score of 0–5) received AIG-IV, 7 (54%) of the 13 patients at high risk for death (sequential organ failure assessment score of 6–11) received treatment. AIG-IV recipients had surgery more often and, among survivors, had longer hospital stays than did nonrecipients. AIG-IV recipients were sicker than nonrecipients. This difference and the small number of higher risk patients confound assessment of AIG-IV effectiveness in this outbreak.

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