>Bacillus species:
1] Bacillus anthracis
2] Bacillus cereus
3] Bacillus subtilis
Bacillus species:
- Ubiquitous gram-positive, rod-shaped bacteria that can be obligate aerobes or facultative anaerobes, and test positive for the enzyme catalase.
- Bacillus are known to form intracellular inclusions of polyhydroxyalkanoates under certain environmental conditions.
- Two Bacillus species are considered medically significant: B. anthracis, which causes anthrax, and B. cereus, which causes a foodborne illness similar to that of Staphylococcus.
- B. subtilis: notable food spoiler, causing ropiness in bread and related food.
- Microscopic examination: Bacillus cells appear as rods, and a substantial portion usually contain an oval endospore at one end, making it bulge.
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| Important considerations: The choice of an agent should be based on local antimicrobial sensitivities, site of infection, cost, and comorbid conditions. Generally, the most common agents/regimens are listed first. Listed dosages may need to be adjusted for renal dysfunction.
Bacillus anthracis:
Bacillus cereus and Bacillus subtilis:
- Clindamycin 600mg IV every 6 or 8 hours or 300mg orally four times daily
- Levofloxacin 500mg – 750 mg IV/PO once daily
- Moxifloxacin 400mg orally/IV qd
- Ciprofloxacin 250-500 mg orally or 200-400mg IV q12h.
- Clarithromycin 500mg po q12h
- Chloramphenicol 50-100 mg/kg/day in divided doses every 6 hours (Maximum daily dose is 4 grams e.g. 1 gram q6h)
- Linezolid 600 mg orally or IV q12h
- Daptomycin 4 – 6 mg/kg IV once daily. NOT FOR PNEUMONIA
- Tigecycline 100 mg IV x 1, then 50 mg q12h
- Imipenem 500mg IV every 6 hours.
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