Rocky Mountain spotted fever medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Overview
The mainstay of therapy for rocky mountain spotted fever is doxycycline. Pharmacologic therapy for Rocky Mountain spotted fever (RMSF) includes either Doxycycline or Chloramphenicol.
Medical Therapy
- Doxycycline is the mainstay of therapy for Rocky Mountain spotted fever. Use of antibiotics other than doxycycline is associated with a higher risk of fatal outcome.
- Treatment is most effective at preventing death if doxycycline is started in the first 5 days of symptoms.
- Empirical antibiotic therapy should be initiated immediately when there is a suspicion of Rocky Mountain spotted fever on the basis of clinical and epidemiologic findings.
- Treatment should not be delayed until laboratory confirmation is obtained.
- If the patient is treated within the first 4-5 days of the disease, fever generally subsides within 24-72 hours.
- Failure to respond to doxycycline argues against a diagnosis of RMSF.
- Severely ill patients may require longer periods before their fever resolves, especially if they have experienced damage to multiple organ systems.
- Preventive therapy in non-ill patients who have had recent tick bites is not recommended and may, in fact, only delay the onset of disease. [1]
Antimicrobial regimens
- Rocky Mountain spotted fever[1]
- 1. Adults
- Preferred regimen: Doxycycline 100 mg PO q12h for 7-14 days
- Note: Treatment with antibiotic agents other than doxycycline is associated with worse outcomes.
- 2. Children under 45kg
- Preferred regimen: Doxycycline 2.2 mg/kg PO q12h for 7-14 days
References
- ↑ 1.0 1.1 Rocky Mountain Spotted Fever Symptoms. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/rmsf/symptoms/index.html Accessed on December 30, 2015