Babesiosis medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
The traditional regimen of [[quinine]] and [[clindamycin]] is often poorly tolerated; recent evidence suggests that a regimen of [[atovaquone]] and [[azithromycin]] can be equally effective <ref name=Krause>{{cite journal | author = Krause P, Lepore T, Sikand V, Gadbaw J, Burke G, Telford S, Brassard P, Pearl D, Azlanzadeh J, Christianson D, McGrath D, Spielman A | title = Atovaquone and azithromycin for the treatment of babesiosis | journal = N Engl J Med | volume = 343 | issue = 20 | pages = 1454-8 | year = 2000 | id = PMID 11078770}}</ref>. In life-threatening cases, exchange [[transfusion]] is performed. In this procedure, the infected red blood cells are removed and replaced with fresh ones. | The traditional regimen of [[quinine]] and [[clindamycin]] is often poorly tolerated; recent evidence suggests that a regimen of [[atovaquone]] and [[azithromycin]] can be equally effective <ref name=Krause>{{cite journal | author = Krause P, Lepore T, Sikand V, Gadbaw J, Burke G, Telford S, Brassard P, Pearl D, Azlanzadeh J, Christianson D, McGrath D, Spielman A | title = Atovaquone and azithromycin for the treatment of babesiosis | journal = N Engl J Med | volume = 343 | issue = 20 | pages = 1454-8 | year = 2000 | id = PMID 11078770}}</ref>. In life-threatening cases, exchange [[transfusion]] is performed. In this procedure, the infected red blood cells are removed and replaced with fresh ones. | ||
===Antimicrobial Regimen=== | |||
:* '''Babesiosis treatment''' | |||
::* 1. '''Mild/moderate disease'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref> | |||
::* Preferred regimen: [[Atovaquone]] 750 mg PO bid {{and}} [[Azithromycin]] 600 mg PO qd for 7-10 days | |||
:* 2. '''Severe disease:''' | |||
::* Preferred regimen: [[Clindamycin]] 600 mg PO tid {{and}} [[Quinine]] 650 mg PO tid for 7–10 days | |||
::* Preferred regimen: [[Clindamycin]] 1.2 g IV q12h | |||
::* Note (1): For overwhelming infection in asplenic patients and immunocompromised patients, treat for 6 or more weeks. | |||
::* Note (2): Consider transfusion if 10% parasitemia. | |||
==References== | ==References== | ||
Revision as of 20:20, 28 July 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Most cases of babesiosis resolve without any specific treatment. For ill patients, treatment is usually a two-drug regimen.
Medical Therapy
The traditional regimen of quinine and clindamycin is often poorly tolerated; recent evidence suggests that a regimen of atovaquone and azithromycin can be equally effective [1]. In life-threatening cases, exchange transfusion is performed. In this procedure, the infected red blood cells are removed and replaced with fresh ones.
Antimicrobial Regimen
- Babesiosis treatment
- 1. Mild/moderate disease[2]
- Preferred regimen: Atovaquone 750 mg PO bid AND Azithromycin 600 mg PO qd for 7-10 days
- 2. Severe disease:
- Preferred regimen: Clindamycin 600 mg PO tid AND Quinine 650 mg PO tid for 7–10 days
- Preferred regimen: Clindamycin 1.2 g IV q12h
- Note (1): For overwhelming infection in asplenic patients and immunocompromised patients, treat for 6 or more weeks.
- Note (2): Consider transfusion if 10% parasitemia.
References
- ↑ Krause P, Lepore T, Sikand V, Gadbaw J, Burke G, Telford S, Brassard P, Pearl D, Azlanzadeh J, Christianson D, McGrath D, Spielman A (2000). "Atovaquone and azithromycin for the treatment of babesiosis". N Engl J Med. 343 (20): 1454–8. PMID 11078770.
- ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.