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AV7909 + ciprofloxacin is a combination therapy consisting of AV7909, a next-generation anthrax vaccine containing Anthrax Vaccine Adsorbed (AVA) with CpG 7909 adjuvant, and ciprofloxacin, a fluoroquinolone antibiotic. This combination is intended for **post-exposure prophylaxis (PEP) of disease following suspected or confirmed exposure to Bacillus anthracis**, and the two agents are administered together: AV7909 is given intramuscularly, while ciprofloxacin is administered orally. AV7909 works by inducing an immune response against anthrax toxin via stimulation of anti-protective antigen antibodies (primarily through AVA and enhanced by CpG 7909’s TLR9 agonism), and ciprofloxacin acts by inhibiting bacterial DNA gyrase and topoisomerase IV, thus killing Bacillus anthracis directly. Combination use is supported by animal studies showing **added benefit in survival versus antibiotic alone**, and clinical studies demonstrate **no clinically significant pharmacokinetic or immunogenicity interaction** when the two are administered together[1][3][4].
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