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Kaplan-Meier survival curves of the first 43 attempts to replicate the Milwaukee protocol, using intention-to-treat. Approximately half of the attempts met the 2 assumptions and included key drugs. Attempts occurred in Brazil (8), Canada (2), Colombia (2), Dominican Republic (3), Equatorial Guinea (6), Germany (4), India, Italy, Netherlands, Peru (2), Qatar, South Africa, Thailand, UK (2) and USA (8). Cases treated with approximations to version 1 of the protocol are in red; cases treated with approximations to version 2 of the protocol are in green; cases with approximations to version 3 are in orange, cases with approximations to version 4 are in aquamarine. Included for comparison are rabies cases (in blue) restricted to Western Europe, Japan, Canada and United States in 2000-2010 that were published in PubMed or ProMED. Survival using any version of the Milwaukee protocol is significantly longer (p=0.0001) than for contemporary controls.
The materials made available at this site are intended as general medical information and are not intended to constitute a recommendation as to a course of medical treatment for any specific patient. They are provided for the limited purpose of assisting clinicians as they evaluate available treatment options. These materials represent the insights and opinions of physicians involved in treatment of patients with rabies and are not the result of activities pursuant to an approved research protocol, and they should be evaluated on that basis. The information provided at this site is based on a very limited experience and therefore may not be applicable in any other situation. Each rabies patient is unique, and factors such as general good health, excellent and adaptive medical intensive care, and careful avoidance of mistakes and complications of intensive care may prove to be essential to positive outcomes.
The information, including the identification of key issues, and the recommendations provided remain preliminary in nature. As noted, they do not constitute the current standard of care. These materials will be modified as additional data is accumulated. The risks associated with the course of treatment described generally in these materials must be understood and carefully evaluated by physician and patient before treatment decisions are made. Any additional information that other clinicians or researchers may provide related to the treatment of rabies in other patients is greatly appreciated.
All materials ©2005 The Medical College of Wisconsin, Inc.
We are very interested in hearing constructive comments on the Milwaukee protocol, but it is much more important that patients receiving the Milwaukee protocol or its components be registered so that this information can be shared openly with the international medical community.
We are also happy to share experiences on the management of patients with rabies. Please recognize that the Web site and e-mail links are operated under minimal budget and by few individuals. We cannot guarantee 24 hours daily / 7 days weekly responses to e-mails, but will try our best to respond quickly. The Centers for Disease Control, Rabies Branch (404-639-1050; after hours: 770 488 7100) always has experts on call to assist in the diagnosis and management of rabies.