Psittacosis medical therapy: Difference between revisions

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Revision as of 12:55, 3 August 2015

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The infection is treated with antibiotics. Remission of symptoms usually is evident within 48-72 hours. However, relapse can occur, and treatment must continue for at least 10-14 days after fever abates

Medical Therapy

Antimicrobial Regimen

1. Psittacosis ^[1]

1.1 Adult

Preferred regimen (1): Doxycycline 100 mg PO bid for 10-21 days
Preferred regimen (2): Tetracycline 500 mg PO qid for 10-21 days
Alternative regimen: Minocycline

1.2 Pediatric

1.2.1 Mild infection, Infants >3 months

Preferred regimen: Azithromycin 10 mg/kg PO qd on day 1 THEN 5 mg/kg PO q24h for 4 days; (Maximum, 500 mg for 1st dose, 250 mg for subsequent doses)

1.2.2 Moderate-severe infection, Infants >3 months

Preferred regimen: Azithromycin 10 mg/kg IV q24h for 2 days THEN 5 mg/kg PO qd for 3 days; (Maximum, 500 mg/dose IV; 250 mg/dose PO)

1.3 Pregnant Patients

Preferred regimen: Azithromycin 500 mg PO on day 1 THEN by 250 mg qd on days 2-5 OR 500 mg IV as a single dose for at least 2 days, followed by 500 mg PO qd for 7- 10 days

References

↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013.

Template:WikiDoc Sources

[1] Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013.

[1]

@@ Line 5: / Line 5: @@
 The infection is treated with [[antibiotic]]s.  Remission of symptoms usually is evident within 48-72 hours. However, relapse can occur, and treatment must continue for at least 10-14 days after fever abates
 ==Medical Therapy==
-*[[Tetracycline]]s and [[chloramphenicol]] are the drugs of choice for treating patients with psittacosis.
+===Antimicrobial Regimen===
-*Most persons respond to:
-**Oral therapy (100 mg of [[doxycycline]] administered twice a day.
+:* 1. ''' Psittacosis '''<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>
-**500 mg of [[tetracycline]] hydrochloride administered four times a day.
+::* 1.1 '''Adult'''
-**500 mg of [[chloramphenicol]] palmitate orally every 6 hours.
+:::* Preferred regimen (1): [[Doxycycline]] 100 mg PO bid for 10-21 days
-*For initial treatment of '''severely ill''' patients, doxycycline cyclate may be administered [[intravenous]]ly at a dosage of 4.4 mg/kg (2 mg/lb) body weight per day divided into two infusions per day (up to 100 mg per dose).
+:::* Preferred regimen (2): [[Tetracycline]] 500  mg PO qid for 10-21 days
-*In past years, tetracycline hydrochloride has been administered to patients intravenously (10-15 mg/kg body weight per day divided into four doses per day).
+:::* Alternative regimen: [[Minocycline]]
-*Remission of symptoms usually is evident within 48-72 hours. However, relapse can occur, and treatment must continue for at least 10-14 days after fever abates.
+::* 1.2 '''Pediatric'''
-*Although its [[in vivo]] efficacy has not been determined, [[erythromycin]] probably is the best alternative agent for persons for whom tetracycline is contraindicated (''e.g.'', children aged less than 9 years and [[pregnant]] women).
+:::* 1.2.1 '''Mild infection, Infants >3 months'''
+::::* Preferred regimen: [[Azithromycin ]] 10 mg/kg PO qd on day 1 {{then}} 5 mg/kg PO q24h  for 4 days; (Maximum, 500 mg for 1st dose, 250 mg for subsequent doses)
+:::* 1.2.2 '''Moderate-severe infection, Infants  >3 months'''
+::::* Preferred regimen: [[Azithromycin ]] 10 mg/kg IV q24h for 2 days {{then}} 5 mg/kg PO qd for 3 days; (Maximum, 500 mg/dose IV; 250 mg/dose PO)
+::* 1.3 '''Pregnant Patients'''
+:::* Preferred regimen: [[Azithromycin ]] 500 mg PO on day 1 {{then}} by 250 mg qd on days 2-5  {{or}}  500 mg  IV as a single dose for at least 2 days, followed by 500 mg  PO qd  for 7- 10 days
 ==References==