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* Complications of brucellosis | * Complications of brucellosis | ||
:* Spondylitis | :* Spondylitis | ||
::* Preferred regimen: Continuation of [[Doxycycline]] for eight weeks or more; Surgical drainage is rarely necessary. | |||
:* Neurobrucellosis | :* Neurobrucellosis | ||
::* Preferred regimen: [[Rifampicin]] {{or}} [[Trimethoprim/sulfamethoxazole]], be added to the standard regimen of [[Doxycycline]] {{and}} [[Streptomycin]] for 6-8 weeks, and possibly longer, depending on the clinical response | |||
:* Brucella endocarditis | :* Brucella endocarditis | ||
::* Preferred regimen: | |||
* For children less than eight years of age | * For children less than eight years of age |
Revision as of 19:30, 16 June 2015
Anaplasmosis
- Human granulocytic anaplasmosis, suspected or symptomatic [1]
- Preferred regimen: Doxycycline 100 mg orally bid (or intravenously for those patients unable to take an oral medication) for 10 days
- Alternative regimen: Rifampin 300 mg orally bid for 7–10 days (For patients with mild illness due to HGA who are not optimally suited for doxycycline treatment because of a history of drug allergy, pregnancy, or age <8 years)
- Pediatric regimen: Doxycycline 4 mg/kg per day in 2 divided doses (maximum of 100 mg per dose) given orally (or intravenously for children unable to take an oral medication); Rifampin 10 mg/kg bid for children (maximum of 300 mg per dose) (For children age <8 years without Lyme disease)
- NOTE (1): Children ≥8 years of age may be treated with a 10-day course of Doxycycline; For severely ill children <8 years of age without concomitant Lyme disease, the panel recommended an abbreviated treatment course of 4–5 days
- NOTE (2): If the patient has concomitant Lyme disease, then Amoxicillin 50 mg/kg per day in 3 divided doses (maximum of 500 mg per dose) OR Cefuroxime axetil 30 mg/kg per day in 2 divided doses (maximum of 500 mg per dose) should be initiated at the conclusion of the course of Doxycycline to complete a 14-day total course of antibiotic therapy
- NOTE: Rifampin is not effective therapy for Lyme disease, patients coinfected with B. burgdorferi should also be treated with Amoxicillin OR Cefuroxime axetil
Brucellosis
- Uncomplicated brucellosis in adults and children eight years of age and older
- Preferred regimen: Doxycycline 100 mg bid for six weeks OR Tetracycline 500 mg every six hours orally administered for at least six weeks
- NOTE: Streptomycin 1 g/day intramuscularly administered for the first two to three weeks of therapy OR Gentamicin 5mg/kg/day intravenously or intramuscularly for 7-10 days in combination with Doxycycline administered for six weeks
- Alternative regimen (1): Doxycycline 200 mg/day orally AND Rifampicin 600–900 mg/day orally, both drugs administered for six weeks
- Alternative regimen (2): Fluoroquinolones
- NTOE: Quinolones should always be used in combination with other drugs, such as Doxycycline or Rifampicin
- Alternative regimen (3): TMP/SMZ in a fixed ratio of 1:5 (80 mg TMP/400 mg SMZ)
- NOTE: TMP/SMZ should always be used in combination with another agent, such as Doxycycline, Rifampicin or Streptomycin
- Complications of brucellosis
- Spondylitis
- Preferred regimen: Continuation of Doxycycline for eight weeks or more; Surgical drainage is rarely necessary.
- Neurobrucellosis
- Preferred regimen: Rifampicin OR Trimethoprim/sulfamethoxazole, be added to the standard regimen of Doxycycline AND Streptomycin for 6-8 weeks, and possibly longer, depending on the clinical response
- Brucella endocarditis
- Preferred regimen:
- For children less than eight years of age
- Preferred regimen:
- Alternative regimen:
Ehrlichiosis
Tularemia
Typhoid fever
References
- ↑ Wormser GP, Dattwyler RJ, Shapiro ED, Halperin JJ, Steere AC, Klempner MS; et al. (2006). "The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America". Clin Infect Dis. 43 (9): 1089–134. doi:10.1086/508667. PMID 17029130.