{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T13:31:53Z","timestamp":1789651913490,"version":"4.0.0"},"reference-count":34,"publisher":"American Society for Microbiology","license":[{"start":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T00:00:00Z","timestamp":1714435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/doi.org\/10.1128\/ASMCopyrightv2"},{"start":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T00:00:00Z","timestamp":1714435200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100020594","name":"Israel Institute for Biological Research","doi-asserted-by":"crossref","award":["Self funding"],"award-info":[{"award-number":["Self funding"]}],"id":[{"id":"10.13039\/501100020594","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:p>\n              Efficient treatment of anthrax-related meningitis in patients poses a significant therapeutic challenge. Previously, we demonstrated in our anthrax meningitis rabbit model that ciprofloxacin treatment is ineffective with most of the treated animals succumbing to the infection. Herein we tested the efficacy of doxycycline in our rabbit model and found it highly effective. Since all of our findings are based on a rabbit model, we test the efficacy of ciprofloxacin or doxycycline in a specific central nervous system (CNS) model developed in non-human primates (NHPs). Similar to rabbits, ciprofloxacin treatment was ineffective, while doxycycline protected the infected rhesus macaques (\n              <jats:italic>n<\/jats:italic>\n              = 2) from the lethal CNS\n              <jats:italic>Bacillus anthracis<\/jats:italic>\n              infection. To test whether the low efficacy of Ciprofloxacin is an example of low efficacy of all fluoroquinolones or only this substance, we treated rabbits that were inoculated intracisterna magna (ICM) with levofloxacin or moxifloxacin. We found that in contrast to ciprofloxacin, levofloxacin and moxifloxacin were highly efficacious in treating lethal anthrax-related meningitis in rabbits and NHP (levofloxacin). We demonstrated (in na\u00efve rabbits) that this difference probably results from variances in blood\u2013brain-barrier penetration of the different fluoroquinolones. The combined treatment of doxycycline and any one of the tested fluoroquinolones was highly effective in the rabbit CNS infection model. The combined treatment of doxycycline and levofloxacin was effective in an inhalation rabbit model, as good as the doxycycline mono-therapy. These findings imply that while ciprofloxacin is highly effective as a post-exposure prophylactic drug, using this drug to treat symptomatic patients should be reconsidered.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1128\/aac.01610-23","type":"journal-article","created":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T13:02:07Z","timestamp":1714482127000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":3,"title":["Doxycycline, levofloxacin, and moxifloxacin are superior to ciprofloxacin in treating anthrax meningitis in rabbits and NHP"],"prefix":"10.1128","author":[{"given":"Amir","family":"Ben-Shmuel","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itai","family":"Glinert","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assa","family":"Sittner","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elad","family":"Bar-David","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"Schlomovitz","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1902-8535","authenticated-orcid":false,"given":"Haim","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0634-7817","authenticated-orcid":false,"given":"Shay","family":"Weiss","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","published-online":{"date-parts":[[2024,4,30]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199909093411107"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-80451-9_2"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra012892"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-662-05767-4_1"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2612.191373"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiph.2010.07.004"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid0807.020062"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2002.120921"},{"key":"e_1_3_2_10_2","unstructured":"CDC. 2020. Types of anthrax. Available from: https:\/\/www.cdc.gov\/anthrax\/basics\/types\/index.html"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1980.tb18910.x"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a120135"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a120131"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268811001488"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/344801b0"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1080\/13623690208409635"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1080\/08998280.2005.11928074"},{"key":"e_1_3_2_18_2","volume-title":"Review of the scientific approaches used during the FBI's investigation of the 2001 anthrax letters","author":"Council NR NR","year":"2011","unstructured":"Council NR NR. 2011. Review of the scientific approaches used during the FBI's investigation of the 2001 anthrax letters. The National Academies Press, Washington, DC."},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid0810.020353"},{"key":"e_1_3_2_20_2","article-title":"Update: investigation of bioterrorism-related anthrax and interim guidelines for clinical evaluation of persons with possible anthrax","author":"CDC","year":"2001","unstructured":"CDC. 2001. Update: investigation of bioterrorism-related anthrax and interim guidelines for clinical evaluation of persons with possible anthrax. MMWR Morb Mortal Wkly Rep","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid0706.010604"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr6404a1"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0112319"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0186613"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.15252\/embj.201696264"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0228917"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01689-10"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1354\/vp.44-5-716"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/0300985810378112"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2020.04.036"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1086"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01376-15"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr7206a1"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.00244-12"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0264-410x(01)00021-4"}],"container-title":["Antimicrobial Agents and Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/aac.01610-23","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/aac.01610-23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T13:02:54Z","timestamp":1714482174000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/aac.01610-23"}},"subtitle":[],"editor":[{"given":"Helen","family":"Boucher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,4,30]]},"references-count":34,"alternative-id":["10.1128\/aac.01610-23"],"URL":"https:\/\/doi.org\/10.1128\/aac.01610-23","relation":{},"ISSN":["0066-4804","1098-6596"],"issn-type":[{"value":"0066-4804","type":"print"},{"value":"1098-6596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,30]]},"assertion":[{"value":"2023-12-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e01610-23"}}