Biology subjects

Schlomovitz, J.

Publications and source records attributed to Schlomovitz, J..

3 recordsLinked to original sources

bioRxiv2025

Efficacy of Doxycycline as monotherapy or in combination with Levofloxacin in treating late-stage systemic anthrax in NHP

Bacillus anthracis spores pose a major biosecurity threat, in light of their use in several documented bio-terror attacks and the fact that it was weaponized. The absence of specific and accurate treatment instructions in the 2001 anthrax letter attacks and the poor prognosis of patient receiving noneffective treatment, emphasized the need for reliable guidelines for treating exposed(prophylaxis) or symptomatic populations. The recent 2024 CDC guidelines for treating systemic anthrax recommend a combined treatment of a tetracycline (Minocycline or Doxycycline) with Meropenem or a fluoroquinolone. These recommendations differ from the 2001 or 2015 updates, and in the absence of significant clinical data, rely on animal studies. Previously we demonstrated, based on a rabbit model, that these recommendations are efficient in treating various stages of anthrax, ranging from post exposure prophylaxis, through systemic to involvement of the CNS. Herein we confirm our rabbit results by demonstrating the efficacy of Doxycycline as a monotherapy or in combination with Levofloxacin in treating late-stage systemic anthrax in non-human primates (NHP), in a trigger to treat type of experiment. Our experiments show high efficacy of the mono or combined therapy. Altogether, these results support the CDC guidelines by demonstrating the efficacy of this treatment in a second highly relevant NHP model.

pharmacology and toxicology↗

bioRxiv2024

Closing the gaps: testing the efficacy of carbapenem and cephalosporins in treating late-stage anthrax

Anthrax is a fatal zoonotic disease caused by exposure to Bacillus anthracis spores. Treatment of systemic anthrax is usually efficient when using the right antibiotics as close as possible to exposure, preferably prior to symptoms onset as post exposure prophylaxis (PEP). The efficacy decreases as treatment is initiated later in disease progression. The CDC in its guidelines divides anthrax treatment to three different indications according to the progression of the disease: PEP, systemic and systemic with indications of CNS infection. While the prognosis of PEP or early treatment of systemic anthrax is very good, ingress of the bacteria into the CNS significantly decreases treatment efficacy, creating a substantial clinical challenge. Since anthrax in humans is rare, the CDC recommendations are mainly based on animal model experiments and data obtained from patients infected with other pathogens. Here we use rabbits to test the efficacy of the combined treatment of Meropenem and Doxycycline which is the first choice in the CDC recommendations for treating systemic patients with indication of CNS infection. In addition, we test the efficacy of the first-generation cephalosporin, cefazolin, in treating the different stages of the disease. We found that the combination of Doxycycline and Meropenem is highly effective in treating rabbits in our inhalation and CNS infection models. Cefazoline was efficient only as PEP or systemic stage treatment but not CNS infected animals. Our findings support the CDC recommendation of using a combination of Doxycycline and Meropenem for systemic patients with or without indications for CNS infection. We found that Cefazoline is a decent choice for PEP or early sage systemic disease but recommend considering using this antibiotic only if all other options are not available.

microbiology↗

bioRxiv2023

Doxycycline Levofloxacin or Moxifloxacin are superior to ciprofloxacin in treating anthrax meningitis in rabbits

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 in 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. 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 intra cisterna magna (ICM) with Levofloxacin or Moxifloxacin. We found that in contrast to Ciprofloxacin, Levofloxacin and Moxifloxacin were highly efficient in treating lethal anthrax related meningitis in rabbits. We demonstrated (in naive rabbits) that this deference probably results from variances in blood brain barrier (BBB) 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 inhalation rabbit model, as good as the doxycycline monotherapy. 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.

microbiology↗