Yersinia pestis infection medical therapy: Difference between revisions
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===Specific Therapy=== | ===Specific Therapy=== | ||
====Aminoglycosides==== | ====Aminoglycosides==== | ||
'''Streptomycin''' is the most effective [[antibiotic]] against [[Yersinia pestis]] and the [[drug]] of choice for treatment of [[plague]], particularly the pneumonic form. Therapeutic effect may be expected with ''30 mg/kg/day'' (up to a total of 2 g/day) in divided doses given [[intramuscularly]], to be continued for a full course of 10 days of therapy or until 3 days after the temperature has returned to normal.<ref name="pmid10635759">{{cite journal| author=| title=Plague manual--epidemiology, distribution, surveillance and control. | journal=Wkly Epidemiol Rec | year= 1999 | volume= 74 | issue= 51-52 | pages= 447 | pmid=10635759 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10635759 }} </ref><ref>{{Cite book | last1 = Longo | first1 = Dan L. (Dan Louis) | title = Harrison's principles of internal medici | date = 2012 | publisher = McGraw-Hill | location = New York | isbn = 978-0-07-174889-6 | pages = }}</ref<ref name="pmid13139207">{{cite journal| author=SMADEL JE, WOODWARD TE, AMIES CR, GOODNER K| title=Antibiotics in the treatment of bubonic and pneumonic plague in man. | journal=Ann N Y Acad Sci | year= 1952 | volume= 55 | issue= 6 | pages= 1275-84 | pmid=13139207 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13139207 }} </ref><ref name="MeyerQuan1952">{{cite journal|last1=Meyer|first1=K. F.|last2=Quan|first2=S. F.|last3=McCrumb|first3=F. R.|last4=Larson|first4=A.|title=EFFECTIVE TREATMENT OF PLAGUE|journal=Annals of the New York Academy of Sciences|volume=55|issue=6|year=1952|pages=1228–1274|issn=00778923|doi=10.1111/j.1749-6632.1952.tb22687.x}}</ref><ref name="pmid1262715">{{cite journal| author=Butler T, Levin J, Linh NN, Chau DM, Adickman M, Arnold K| title=Yersinia pestis infection in Vietnam. II. Quantiative blood cultures and detection of endotoxin in the cerebrospinal fluid of patients with meningitis. | journal=J Infect Dis | year= 1976 | volume= 133 | issue= 5 | pages= 493-9 | pmid=1262715 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1262715 }} </ref> | |||
'''Streptomycin''' is the most effective [[antibiotic]] against [[Yersinia pestis]] and the [[drug]] of choice for treatment of [[plague]], particularly the pneumonic form. Therapeutic effect may be expected with ''30 mg/kg/day'' (up to a total of 2 g/day) in divided doses given [[intramuscularly]], to be continued for a full course of 10 days of therapy or until 3 days after the temperature has returned to normal. | |||
'''Gentamicin''' has been found to be effective in animal studies, and is used to treat human plague patients.<ref name="pmid10635759">{{cite journal| author=| title=Plague manual--epidemiology, distribution, surveillance and control. | journal=Wkly Epidemiol Rec | year= 1999 | volume= 74 | issue= 51-52 | pages= 447 | pmid=10635759 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10635759 }} </ref> | |||
Revision as of 13:52, 25 July 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editors-In-Chief: Esther Lee, M.A.; João André Alves Silva, M.D. [2]
Overview
According to treatment experts, a patient diagnosed with suspected plague should be hospitalized and medically isolated. Laboratory tests should be done, including blood cultures for plague bacteria and microscopic examination of lymph gland, blood, and sputum samples. Antibiotic treatment should begin as soon as possible after laboratory specimens are taken. Effective antibiotics are streptomycin, gentamicin (used when streptomycin is not available), tetracyclines and chloramphenicol. (used for critically ill patients, or rarely for suspected neuro-involvement)
Medical Therapy
When a diagnosis of human plague is suspected on clinical and epidemiological grounds, appropriate specimens for diagnosis should be obtained immediately and the patient should be started on specific antimicrobial therapy without waiting for a definitive answer from the laboratory.
Suspect plague patients with evidence of pneumonia should be placed in isolation, and managed under respiratory droplet precautions.[1]
Specific Therapy
Aminoglycosides
Streptomycin is the most effective antibiotic against Yersinia pestis and the drug of choice for treatment of plague, particularly the pneumonic form. Therapeutic effect may be expected with 30 mg/kg/day (up to a total of 2 g/day) in divided doses given intramuscularly, to be continued for a full course of 10 days of therapy or until 3 days after the temperature has returned to normal.[2]Closing </ref> missing for <ref> tag[3][4]
Gentamicin has been found to be effective in animal studies, and is used to treat human plague patients.[2]
References
- ↑ Garner JS (1996). "Guideline for isolation precautions in hospitals. The Hospital Infection Control Practices Advisory Committee". Infect Control Hosp Epidemiol. 17 (1): 53–80. PMID 8789689.
- ↑ 2.0 2.1 "Plague manual--epidemiology, distribution, surveillance and control". Wkly Epidemiol Rec. 74 (51–52): 447. 1999. PMID 10635759.
- ↑ Meyer, K. F.; Quan, S. F.; McCrumb, F. R.; Larson, A. (1952). "EFFECTIVE TREATMENT OF PLAGUE". Annals of the New York Academy of Sciences. 55 (6): 1228–1274. doi:10.1111/j.1749-6632.1952.tb22687.x. ISSN 0077-8923.
- ↑ Butler T, Levin J, Linh NN, Chau DM, Adickman M, Arnold K (1976). "Yersinia pestis infection in Vietnam. II. Quantiative blood cultures and detection of endotoxin in the cerebrospinal fluid of patients with meningitis". J Infect Dis. 133 (5): 493–9. PMID 1262715.