{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:00:17Z","timestamp":1762866017660},"reference-count":26,"publisher":"American Society for Microbiology","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin. Vaccine Immunol."],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Inhalation anthrax is a potentially lethal form of disease resulting from exposure to aerosolized<jats:named-content content-type=\"genus-species\">Bacillus anthracis<\/jats:named-content>spores. Over the last decade, incidents spanning from the deliberate mailing of<jats:named-content content-type=\"genus-species\">B. anthracis<\/jats:named-content>spores to incidental exposures in users of illegal drugs have highlighted the importance of developing new medical countermeasures to protect people who have been exposed to \u201canthrax spores\u201d and are at risk of developing disease. The New Zealand White rabbit (NZWR) is a well-characterized model that has a pathogenesis and clinical presentation similar to those seen in humans. This article reports how the NZWR model was adapted to evaluate postexposure prophylaxis using a recombinant protective antigen (rPA) vaccine in combination with an oral antibiotic, levofloxacin. NZWRs were exposed to multiples of the 50% lethal dose (LD<jats:sub>50<\/jats:sub>) of<jats:named-content content-type=\"genus-species\">B. anthracis<\/jats:named-content>spores and then vaccinated immediately (day 0) and again on day 7 postexposure. Levofloxacin was administered daily beginning at 6 to 12 h postexposure for 7 treatments. Rabbits were evaluated for clinical signs of disease, fever, bacteremia, immune response, and survival. A robust immune response (IgG anti-rPA and toxin-neutralizing antibodies) was observed in all vaccinated groups on days 10 to 12. Levofloxacin plus either 30 or 100 \u03bcg rPA vaccine resulted in a 100% survival rate (18 of 18 per group), and a vaccine dose as low as 10 \u03bcg rPA resulted in an 89% survival rate (16 of 18) when used in combination with levofloxacin. In NZWRs that received antibiotic alone, the survival rate was 56% (10 of 18). There was no adverse effect on the development of a specific IgG response to rPA in unchallenged NZWRs that received the combination treatment of vaccine plus antibiotic. This study demonstrated that an accelerated two-dose regimen of rPA vaccine coadministered on days 0 and 7 with 7 days of levofloxacin therapy results in a significantly greater survival rate than with antibiotic treatment alone. Combination of vaccine administration and antibiotic treatment may be an effective strategy for treating a population exposed to aerosolized<jats:named-content content-type=\"genus-species\">B. anthracis<\/jats:named-content>spores.<\/jats:p>","DOI":"10.1128\/cvi.00240-12","type":"journal-article","created":{"date-parts":[[2012,6,14]],"date-time":"2012-06-14T03:51:57Z","timestamp":1339645917000},"page":"1158-1164","source":"Crossref","is-referenced-by-count":24,"title":["Recombinant Protective Antigen Anthrax Vaccine Improves Survival when Administered as a Postexposure Prophylaxis Countermeasure with Antibiotic in the New Zealand White Rabbit Model of Inhalation Anthrax"],"prefix":"10.1128","volume":"19","author":[{"given":"Elizabeth K.","family":"Leffel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James S.","family":"Bourdage","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. Diane","family":"Williamson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Duchars","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas R.","family":"Fuerst","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter C.","family":"Fusco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","published-online":{"date-parts":[[2012,6,13]]},"reference":[{"key":"key20180919073615_B1","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1128\/MMBR.30.3.646-659.1966","article-title":"Industrial inhalation anthrax","volume":"30","author":"Brachman","year":"1966","journal-title":"Bacteriol. 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