Legionellosis medical therapy: Difference between revisions
Jump to navigation
Jump to search
Gerald Chi- (talk | contribs) |
m (Changes made per Mahshid's request) |
||
| (16 intermediate revisions by 4 users not shown) | |||
| Line 3: | Line 3: | ||
{{CMG}} | {{CMG}} | ||
==Overview== | |||
Pharmacologic medical therapy is indicated in Legionnaires' disease. The preferred regimens for both mild and moderate-to-severe pneumonia include either [[azithromycin]] or a [[fluoroquinolone]]. Patients who develop legionellosis-related complications may require other or additional pharmacologic agents. Pontiac fever is self-limited and may be treated with symptomatic therapy only. | |||
==Medical Therapy== | ==Medical Therapy== | ||
===Antimicrobial Regimen=== | ===Antimicrobial Regimen=== | ||
:* 1. '''Atypical pneumonia (Legionnaires' disease)'''<ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref> | :* 1. '''Atypical pneumonia (Legionnaires' disease)'''<ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref> | ||
::* 1.1 '''Mild pneumonia inpatient or outpatient | ::* 1.1 '''Mild pneumonia, non-immunocompromised (inpatient or outpatient)''' | ||
:::* Preferred regimen (1): [[Azithromycin]] 500 mg PO qd for 3-5 days | :::* Preferred regimen (1): [[Azithromycin]] 500 mg PO qd for 3-5 days | ||
:::* Preferred regimen (2): [[Levofloxacin]] 500 mg PO qd for 7-10 days | :::* Preferred regimen (2): [[Levofloxacin]] 500 mg PO qd for 7-10 days | ||
| Line 29: | Line 29: | ||
:::* Alternative regimen (4): [[Clarithromycin]] 500 mg IV q12h for 3-7 days {{then}} 500 mg PO bid for a total course of 21 days | :::* Alternative regimen (4): [[Clarithromycin]] 500 mg IV q12h for 3-7 days {{then}} 500 mg PO bid for a total course of 21 days | ||
:::* Note: Severely ill patients parenteral therapy is advised until improvement is seen and oral absorption is sufficient. | :::* Note: Severely ill patients parenteral therapy is advised until improvement is seen and oral absorption is sufficient. | ||
:* 2 '''Pontiac fever''' <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref> | :* 2. '''Pontiac fever'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref> | ||
::* Pontiac fever is febrile, self-limited form of Legionella infection which requires only symptomatic therapy, such as analgesics for headache. Antibiotics are not indicated. | ::* Pontiac fever is febrile, self-limited form of Legionella infection which requires only symptomatic therapy, such as analgesics for headache. Antibiotics are not indicated. | ||
:* 3. '''Endocarditis'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref> | :* 3. '''Endocarditis'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref> | ||
| Line 39: | Line 39: | ||
[[Category:Infectious Disease Project]] | [[Category:Infectious Disease Project]] | ||
[[Category:Pulmonology]] | [[Category:Pulmonology]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Bacterial diseases]] | [[Category:Bacterial diseases]] | ||
[[Category:Medical disasters]] | [[Category:Medical disasters]] | ||
{{WikiDoc Help Menu}} | {{WikiDoc Help Menu}} | ||
{{WikiDoc Sources}} | {{WikiDoc Sources}} | ||
Latest revision as of 18:09, 18 September 2017
|
Legionellosis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Legionellosis medical therapy On the Web |
|
American Roentgen Ray Society Images of Legionellosis medical therapy |
|
Risk calculators and risk factors for Legionellosis medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pharmacologic medical therapy is indicated in Legionnaires' disease. The preferred regimens for both mild and moderate-to-severe pneumonia include either azithromycin or a fluoroquinolone. Patients who develop legionellosis-related complications may require other or additional pharmacologic agents. Pontiac fever is self-limited and may be treated with symptomatic therapy only.
Medical Therapy
Antimicrobial Regimen
- 1. Atypical pneumonia (Legionnaires' disease)[1]
- 1.1 Mild pneumonia, non-immunocompromised (inpatient or outpatient)
- Preferred regimen (1): Azithromycin 500 mg PO qd for 3-5 days
- Preferred regimen (2): Levofloxacin 500 mg PO qd for 7-10 days
- Preferred regimen (3): Ciprofloxacin 500 mg PO bid for 7-10 days
- Preferred regimen (4): Moxifloxacin 400 mg PO qd for 7-10 days
- Preferred regimen (5): Clarithromycin 500 mg PO bid for 10-14 days
- Alternative regimen (1): Doxycycline 200 mg PO loading dose THEN 100 mg PO bid for 10-14 days
- Alternative regimen (2): Erythromycin 500 mg PO qid for 10-14 days
- Note: Patients with mild disease may be treated entirely with oral therapy
- 1.2 Moderate to severe pneumonia or immunocompromised
- Preferred regimen (1): Azithromycin 500 mg PO/IV q24h for 5-7 days
- Preferred regimen (2): Levofloxacin 500 mg PO/IV q24h for 7-10 days OR 750 mg PO/IV q24h for 5-7 days
- Alternative regimen (1): Ciprofloxacin 750 mg PO bid for 14 days
- Alternative regimen (2): Moxifloxacin 400 mg PO qd for 14 days
- Alternative regimen (3): Erythromycin 750-1000 mg IV q6h for 3-7 days THEN 500 mg PO qid for a total course of 21 days
- Alternative regimen (4): Clarithromycin 500 mg IV q12h for 3-7 days THEN 500 mg PO bid for a total course of 21 days
- Note: Severely ill patients parenteral therapy is advised until improvement is seen and oral absorption is sufficient.
- 2. Pontiac fever[2]
- Pontiac fever is febrile, self-limited form of Legionella infection which requires only symptomatic therapy, such as analgesics for headache. Antibiotics are not indicated.
- 3. Endocarditis[3]
- Preferred regimen (1): Levofloxacin 750 mg PO/IV qd for 7-10 days AND Rifampin 300 mg PO bid for 4-6 weeks
- Preferred regimen (2): Moxifloxacin 400 mg PO/IV qd for 7-10 days AND Rifampin 300 mg PO bid for 4-6 weeks
References
- ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.